Active NPI
Ashley Rendon, DPT
- Sports Physical Therapist
- Costa Mesa, CA
National Provider Identifier
1265006191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 300163
- Practice address
- 1609 Baker St
Costa Mesa, CA 92626-3701 - Phone
- (949) 791-9401
- NPI assigned
- May 15, 2021
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 300163 | CA | Primary |
Addresses
Primary practice location
1609 Baker St
Costa Mesa, CA 92626-3701
Mailing address
1609 Baker St
Costa Mesa, CA 92626-3701
Phone (949) 791-9401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300163 | Other | CA | LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300163 | CA | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1265006191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 BAKER ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263701",
"telephone_number": "949-791-9401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 BAKER ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263701",
"telephone_number": "949-791-9401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDON",
"first_name": "ASHLEY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-15",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "300163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "300163",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.