Audra Kristen Eisz, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT33850 Issued in CA

Practice address

4520 Executive Drive
Suite101
San Diego, CA 92121

Phone

(858) 535-1075

Fax

(858) 453-9810

NPI assigned

Aug 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Audra Kristen Astiasuain Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1457545535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVENUE",
            "address_2": "SUITE 210",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-535-1075",
            "fax_number": "858-453-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 EXECUTIVE DRIVE",
            "address_2": "SUITE101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-535-1075",
            "fax_number": "858-453-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISZ",
        "first_name": "AUDRA",
        "middle_name": "KRISTEN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT33850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRA",
            "last_name": "ASTIASUAIN",
            "middle_name": "KRISTEN",
            "credential": "PT, DPT, OCS, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Eisenstadt, MFT
• Samuel G. Eisenstein, MD
• Evan Eisher
• Alyssa Eisman, LCSW, CADC II
• David Eisner
• Katie Brigitta Eitel
• Christopher John Eitzen, DDS
• Laurie Maureen Eivet
• Nida Ejaz
• Ejd Medical Corporation

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.