Individual provider Active NPI

Kaylen Danz, PTA

  • Physical Therapy Assistant
  • Redondo Beach, CA
National Provider Identifier
1346839339
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
50940 Issued in CA
Practice address
514 N Prospect Ave
Redondo Beach, CA 90277-3036
Phone
(310) 896-3100
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 50940 CA Primary

Addresses

Primary practice location

514 N Prospect Ave
Redondo Beach, CA 90277-3036

Mailing address

12654 Moorpark St Apt 11
Studio City, CA 91604-1316
Phone (530) 748-7747

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

LicenseStateTypeSpecialty
50940CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1346839339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12654 MOORPARK ST APT 11",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041316",
            "telephone_number": "530-748-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 N PROSPECT AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773036",
            "telephone_number": "310-896-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANZ",
        "first_name": "KAYLEN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.