Active NPI
Priscilla Medina, PTA
- Physical Therapy Assistant
- Santa Ana, CA
National Provider Identifier
1255850541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 48857
- Practice address
- 1030 W Warner Ave
Santa Ana, CA 92707-3147 - Phone
- (714) 546-6450
- NPI assigned
- Sep 18, 2017
- 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 Therapy Assistant | 225200000X | 48857 | CA | Primary |
Addresses
Primary practice location
1030 W Warner Ave
Santa Ana, CA 92707-3147
Mailing address
6831 Red Coach Dr
Huntington Beach, CA 92647-2956
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 |
|---|---|---|---|
| 48857 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1255850541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6831 RED COACH DR",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926472956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 W WARNER AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927073147",
"telephone_number": "714-546-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "PRISCILLA",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-18",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "48857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.