Organization Active NPI

Versa Physical Therapy, Inc

  • Physical Therapist
  • Glendale, CA
National Provider Identifier
1396462446
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
VERSA PHYSICAL THERAPY, INC
Practice address
1030 S Glendale Ave Ste 404
Glendale, CA 91205-2866
Phone
(818) 245-6364
Fax
(818) 350-1119
NPI assigned
Oct 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Lalageh Yaghoubi, PT, DPTNPI 1205588837
Title
Doctor of Physical Therapy/Owner
Phone
(818) 245-6364

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1030 S Glendale Ave Ste 404
Glendale, CA 91205-2866

Mailing address

1030 S Glendale Ave Ste 404
Glendale, CA 91205-2866
Phone (818) 245-6364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221223000627 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6608246244 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

1030 S Glendale Ave
Ste 404
Glendale, CA 91205
Phone (818) 240-9911

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1396462446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE STE 404",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052866",
            "telephone_number": "818-245-6364",
            "fax_number": "818-350-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE STE 404",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052866",
            "telephone_number": "818-245-6364",
            "fax_number": "818-350-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERSA PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "YAGHOUBI",
        "authorized_official_first_name": "LALAGEH",
        "authorized_official_title_or_position": "DOCTOR OF PHYSICAL THERAPY/OWNER",
        "authorized_official_telephone_number": "818-245-6364",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.