Individual provider Active NPI

Krista Lynnette Contreras, PT, DPT

  • Physical Therapist
  • Fullerton, CA
National Provider Identifier
1407383342
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293035 Issued in CA
Practice address
1027 N Harbor Blvd # B
Fullerton, CA 92832-1310
Phone
(714) 870-8478
NPI assigned
May 22, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 293035 CA Primary

Addresses

Primary practice location

1027 N Harbor Blvd # B
Fullerton, CA 92832-1310

Mailing address

2002 Whispering Glen LN
Brea, CA 92821-4359

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170706002383 CA Practitioner - Physical Therapist in Private Practice 8729357793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Total Body Physical Therapy PCGroup PAC ID 3678842663, 12 clinicians
Reekstin Enterprises Inc.Group PAC ID 3678603586, 13 clinicians

Practice addresses (Care Compare)

120 S Chaparral CT
Suite 150
Anaheim, CA 92808-2278
Phone (714) 998-9580

41278 Margarita Rd
Suite 102
Temecula, CA 92591-5579
Phone (951) 587-8105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Core Total Body Physical Therapy, P.C. Physical Therapist CurrentSince Jul 5, 2017 Accepting new patients
Reekstin Enterprises Inc. Physical Therapist CurrentSince May 15, 2017 Accepting new patients
Total Body Physical Therapy Physical Therapist PastSince Jul 5, 2017 Accepting new patients
Choice Physical Therapy Inc PastSince May 15, 2017 Accepting new patients

Locations

120 S Chaparral Ct
Ste 150
Anaheim, CA 92808
Phone (714) 998-9580

1027 N Harbor Blvd
Ste B
Fullerton, CA 92832
Phone (714) 870-8478

41278 Margarita Rd
Ste 102
Temecula, CA 92591
Phone (951) 587-8105

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
C.O.R.E at HomeAnaheim, CA, CCN 757388 Home health agency 5% Or Greater Direct Ownership Interest (8.17%)
Corporate Officer (8.17%)
Corporate Director (8.17%)
May 1, 2024
May 1, 2024
May 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407383342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 WHISPERING GLEN LN",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 N HARBOR BLVD # B",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321310",
            "telephone_number": "714-870-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "KRISTA",
        "middle_name": "LYNNETTE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.