Andivi Manzano, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303204 Issued in CA

Practice address

10515 Balboa Blvd Ste 140
Granada Hills, CA 91344-6350

Phone

(818) 363-0339

Fax

(818) 363-0039

NPI assigned

Nov 10, 2022

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

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD
• Vargo Physical Therapy, Inc.

  • Physical Therapist
  • Northridge, CA
  • NPI 1386768539
  NPD (past)
• Vargo Physical Therapy, Inc.

  • Physical Therapist
  • Santa Clarita, CA
  • NPI 1811910797
  NPD (past)

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1285342998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 140",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446350",
            "telephone_number": "818-363-0339",
            "fax_number": "818-363-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 140",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446350",
            "telephone_number": "818-363-0339",
            "fax_number": "818-363-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANO",
        "first_name": "ANDIVI",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonardo Mangilit, RN
• Alisha Renee Manning
• Michelle Marie Manning, M.A., M.F.T.I,
• Armine T Manokian
• Delaram Manouchehri
• Map Medical Supplies Imc.
• Nathan Sim Marriott, DPT
• Martin F. Strassner, DDS a Professional Corporation
• Marina Martin, LCSW
• Yadira Martinez Cabrera, PPS

• Physical Therapist in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.