Active NPI
Erin Tidwell, PT, DPT
- Physical Therapist
- Seal Beach, CA
National Provider Identifier
1235742289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 299003
- Practice address
- 1005 Pacific Coast Hwy
Seal Beach, CA 90740-6214 - Phone
- (562) 598-5500
- NPI assigned
- Aug 28, 2020
- 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 | 299003 | CA | Primary |
Addresses
Primary practice location
1005 Pacific Coast Hwy
Seal Beach, CA 90740-6214
Mailing address
7928 Phlox St
Downey, CA 90241-4506
Phone (562) 659-5136
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1235742289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7928 PHLOX ST",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902414506",
"telephone_number": "562-659-5136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 PACIFIC COAST HWY",
"city": "SEAL BEACH",
"state": "CA",
"postal_code": "907406214",
"telephone_number": "562-598-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "ERIN",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "299003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seal Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.