Active NPI
Ann Raghavan, PT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1326699240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26022
- Practice address
- 15004 Innovation Dr
San Diego, CA 92128-3491 - Phone
- (858) 605-7189
- NPI assigned
- Sep 23, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 26022 | CA | Primary |
Addresses
Primary practice location
15004 Innovation Dr
San Diego, CA 92128-3491
Mailing address
10790 Rancho Bernard Rd,
Maildrop 4S-205
San Diego, CA 92127-5705
Phone (858) 927-5775
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 |
|---|---|---|---|
| 26022 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1326699240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10790 RANCHO BERNARD RD,",
"address_2": "MAILDROP 4S-205",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921275705",
"telephone_number": "858-927-5775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15004 INNOVATION DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283491",
"telephone_number": "858-605-7189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAGHAVAN",
"first_name": "ANN",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "26022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.