Active NPI
Holly Tesalyn Manansala, PT, DPT
- Physical Therapist
- Redondo Beach, CA
National Provider Identifier
1396107124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT291175
- Practice address
- 1204 S Pacific Coast Hwy
Redondo Beach, CA 90277-4904 - Phone
- (310) 316-3577
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- 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 Therapist | 225100000X | PT291175 | CA | Primary |
Addresses
Primary practice location
1204 S Pacific Coast Hwy
Redondo Beach, CA 90277-4904
Mailing address
1204 S Pacific Coast Hwy
Redondo Beach, CA 90277-4904
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT291175 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458604800000",
"number": "1396107124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 S PACIFIC COAST HWY",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902774904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 S PACIFIC COAST HWY",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902774904",
"telephone_number": "310-316-3577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANANSALA",
"first_name": "HOLLY",
"middle_name": "TESALYN",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2016-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT291175",
"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 Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.