NPIMap

Organization Active NPI

Back to Balance Physical Therapy and Wellness, PC

  • Physical Therapist
  • Laguna Niguel, CA
National Provider Identifier
1174911135
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BACK TO BALANCE PHYSICAL THERAPY AND WELLNESS, PC
Practice address
30101 Town Center Dr
Suite 103
Laguna Niguel, CA 92677-5006
Phone
(949) 444-9917
NPI assigned
Dec 29, 2014
Last updated
Nov 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Dr. Wendy S. Wood, PT, DPT, GCSNPI 1750660171
Title
President/ Ceo
Phone
(949) 444-9917

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X

Addresses

Primary practice location

30101 Town Center Dr
Suite 103
Laguna Niguel, CA 92677-5006

Mailing address

29911 Niguel Rd Unit 6704
Laguna Niguel, CA 92607-2428
Phone (949) 444-9917

National Provider Directory

National Provider Directory

Locations

29911 Niguel Rd
Unit 6704
Laguna Niguel, CA 92607

30101 Town Center Dr
Ste 103
Laguna Niguel, CA 92677
Phone (949) 444-9917

30101 Town Center Dr
Ste 109
Laguna Niguel, CA 92677
Phone (949) 249-4170

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1174911135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29911 NIGUEL RD UNIT 6704",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926072428",
            "telephone_number": "949-444-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30101 TOWN CENTER DR",
            "address_2": "SUITE 103",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775006",
            "telephone_number": "949-444-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BALANCE PHYSICAL THERAPY AND WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "949-444-9917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, GCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.