Liana Raschke Valla

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

8444 Issued in FL

Practice address

4650 State Road 16
St Augustine, FL 32092-0600

Phone

(904) 940-2193

NPI assigned

Aug 11, 2017

Sex

Female

Sole proprietor

No

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 FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Vital Yoga Therapeutics, LLC

  • Neurorehabilitation Occupational Therapist
  • Saint Augustine, FL
  • NPI 1376162289
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1366967283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 SAN JOSE FOREST DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 STATE ROAD 16",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920600",
            "telephone_number": "904-940-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLA",
        "first_name": "LIANA",
        "middle_name": "RASCHKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "FL",
            "license": "8444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Vaeth, BCBA
• Nancy Ann Vail, LMT
• Ronald Gilbert Vail, D.C.
• Jordin Rae Valenti, DDS
• Valerie Deville, LMHC
• Megan Claire Valla
• Laura A Van Horn-Nelson, PA
• Katlyn Van Patten, PT, DPT
• Jennifer Lee Van Wyngaardt, LMT
• Billy Pitapong Vanasupa, D.O.

• Gerontology Occupational Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Gerontology Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; 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.