Individual provider Active NPI

Cres Alaina Avendano, PTA

  • Physical Therapy Assistant
  • Los Angeles, CA
National Provider Identifier
1417406018
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA48036 Issued in CA
Practice address
208 S Normandie Ave Apt 11
Los Angeles, CA 90004-5331
Phone
(323) 580-3023
NPI assigned
Sep 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA48036 CA Primary

Addresses

Primary practice location

208 S Normandie Ave Apt 11
Los Angeles, CA 90004-5331

Mailing address

208 S Normandie Ave Apt 11
Los Angeles, CA 90004-5331
Phone (323) 580-3023

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

LicenseStateTypeSpecialty
PTA48036CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1417406018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S NORMANDIE AVE APT 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045331",
            "telephone_number": "323-580-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S NORMANDIE AVE APT 11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045331",
            "telephone_number": "323-580-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENDANO",
        "first_name": "CRES",
        "middle_name": "ALAINA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA48036",
            "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 Sep 26, 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.

Verify at the official NPI Registry.