Rehabilitation Physical Therapy Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

PT2053 Issued in CA

Legal business name

REHABILITATION PHYSICAL THERAPY INC.

Practice address

11534 Valle Vista Rd
Lakeside, CA 92040-1321

Phone

(619) 443-5116

Fax

(619) 443-5347

NPI assigned

Mar 12, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Barbara H Nickerson, PT

Title

Ceo

Phone

(619) 443-5116

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1235370776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11534 VALLE VISTA RD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920401321",
            "telephone_number": "619-443-5116",
            "fax_number": "619-443-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11534 VALLE VISTA RD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920401321",
            "telephone_number": "619-443-5116",
            "fax_number": "619-443-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "NICKERSON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-443-5116",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "PT2053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promising Futures Inc.
• Crystal Lynn Pugh, PSYD
• Pulmonary Outcomes Group LLC
• R & G Pharmacies, Inc. (Leo's Lakeside Pharmacy)
• Susan Denise Regano
• Mathew Mazo Reynolds
• Mykael Richards
• Steven Rivor, PHARM.D.
• Mara Roberto
• Melinda Jean Rodriguez

• Clinic/Center in Lakeside, CA
• Providers in Lakeside, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.