Active NPI
Kelly Marie Preite, MPT
- Physical Therapist
- Glendora, CA
National Provider Identifier
1184956807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 18866
- Practice address
- 416 N Elwood Ave
Glendora, CA 91741-2838 - Phone
- (714) 595-7471
- Fax
- (626) 335-3497
- NPI assigned
- Feb 5, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 18866 | CA | Primary |
Addresses
Primary practice location
416 N Elwood Ave
Glendora, CA 91741-2838
Mailing address
416 N Elwood Ave
Glendora, CA 91741-2838
Phone (714) 595-7471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 18866 | Other | CA | PHYSICAL THERAPY BOARD OF CALIFORNIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 18866 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265328000000",
"number": "1184956807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 N ELWOOD AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917412838",
"telephone_number": "714-595-7471",
"fax_number": "626-335-3497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 N ELWOOD AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917412838",
"telephone_number": "714-595-7471",
"fax_number": "626-335-3497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREITE",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-05",
"last_updated": "2010-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 18866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
"identifier": "PT 18866",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.