Angela Beth Anderson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT8122 Issued in CA

Practice address

752 Glenview Dr
Apt 106
San Bruno, CA 94066-3744

Phone

(408) 679-0216

NPI assigned

Apr 24, 2015

Last updated

Apr 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1174910343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 GLENVIEW DR",
            "address_2": "#106",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663744",
            "telephone_number": "408-679-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 GLENVIEW DR",
            "address_2": "APT 106",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663744",
            "telephone_number": "408-679-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANGELA",
        "middle_name": "BETH",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT8122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alvarez
• Rachel Amato, PT
• Adriana Cabrera Ambeguia
• Toni Ambus, DDS
• Valeria Ampie-Villalobos
• Lincka Anderson
• Raychel Anderson
• Kevin Andresen
• Alyssa Mariel Menor Angara
• Maria Theresa Angara, DDS

• Physical Therapy Assistant in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.