Active NPI
Clemson Rino Fernandez Rillera, PT
- Physical Therapist
- Simi Valley, CA
National Provider Identifier
1447796065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39731
- Practice address
- 1870 Yosemite Ave
Apt. 101
Simi Valley, CA 93063-4272 - Phone
- (347) 218-3379
- NPI assigned
- Jan 7, 2017
- Sex
- Male
- 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 Therapist | 225100000X | 39731 | CA | Primary |
Addresses
Primary practice location
1870 Yosemite Ave
Apt. 101
Simi Valley, CA 93063-4272
Mailing address
1870 Yosemite Ave
Apt. 101
Simi Valley, CA 93063-4272
Phone (347) 218-3379
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y3565534 | Other | CA | CALIFORNIA DRIVER'S LICENSE |
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 |
|---|---|---|---|
| 39731 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483747200000",
"number": "1447796065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1870 YOSEMITE AVE",
"address_2": "APT. 101",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930634272",
"telephone_number": "347-218-3379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 YOSEMITE AVE",
"address_2": "APT. 101",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930634272",
"telephone_number": "347-218-3379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILLERA",
"first_name": "CLEMSON RINO",
"middle_name": "FERNANDEZ",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-07",
"last_updated": "2017-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA DRIVER'S LICENSE",
"identifier": "Y3565534",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.