Active NPI
Carol Burgos
- Physical Therapy Assistant
- Rancho Mission Viejo, CA
National Provider Identifier
1437971371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9519
- Practice address
- 30492 Gateway PL Ste 201
Rancho Mission Viejo, CA 92694-1899 - Phone
- (949) 877-7745
- NPI assigned
- Oct 31, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 9519 | CA | Primary |
Addresses
Primary practice location
30492 Gateway PL Ste 201
Rancho Mission Viejo, CA 92694-1899
Mailing address
67 Via Vicini
Rancho Santa Margarita, CA 92688-3882
Phone (714) 757-8114
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 |
|---|---|---|---|
| 9519 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1437971371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 VIA VICINI",
"city": "RANCHO SANTA MARGARITA",
"state": "CA",
"postal_code": "926883882",
"telephone_number": "714-757-8114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30492 GATEWAY PL STE 201",
"city": "RANCHO MISSION VIEJO",
"state": "CA",
"postal_code": "926941899",
"telephone_number": "949-877-7745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGOS",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-31",
"last_updated": "2024-10-31",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "9519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.