Active NPI
Peter P Villasista
- Physical Therapy Assistant
- Los Angeles, CA
National Provider Identifier
1376931675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT10613
- Practice address
- 631 N Coronado St Apt 1
Los Angeles, CA 90026-3966 - Phone
- (323) 529-7545
- NPI assigned
- Jan 8, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT10613 | CA | Primary |
Addresses
Primary practice location
631 N Coronado St Apt 1
Los Angeles, CA 90026-3966
Mailing address
631 N Coronado St Apt 1
Los Angeles, CA 90026-3966
Phone (323) 529-7545
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 |
|---|---|---|---|
| AT10613 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420675200000",
"number": "1376931675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 N CORONADO ST APT 1",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900263966",
"telephone_number": "323-529-7545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 N CORONADO ST APT 1",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900263966",
"telephone_number": "323-529-7545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLASISTA",
"first_name": "PETER",
"middle_name": "P",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-08",
"last_updated": "2015-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT10613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.