Tara Colleen Obrien, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT292886 Issued in CA

Practice address

1294 W 6TH St Ste 101
San Pedro, CA 90731-2997

Phone

(909) 706-8898

NPI assigned

Aug 2, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1255884797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5621 MANSION CT",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917501659",
            "telephone_number": "909-706-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST STE 101",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312997",
            "telephone_number": "909-706-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "TARA",
        "middle_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT292886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael T O'Donnell, DPT, OCS
• Samantha Louise O'Donnell, M.S.W.
• Colleen Marie O'Hurley
• Leigh Ann Oberjuerge
• Michael J Obrien Jr
• Ocean Marketing Corp
• Oceans Edge Wellness Inc
• Oceanview Living of San Pedro LLC
• Angie Ochoa
• Sharon R Ohara, MFT

• Physical Therapist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.