Individual provider Active NPI

Daniela Stoimenova Hristova, PTA

  • Physical Therapy Assistant
  • Huntington Beach, CA
National Provider Identifier
1477834687
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT4310 Issued in CA
Practice address
9441 Shadwell Dr
Huntington Beach, CA 92646-7213
Phone
(714) 930-5878
Fax
(888) 257-1807
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 AT4310 CA Primary

Addresses

Primary practice location

9441 Shadwell Dr
Huntington Beach, CA 92646-7213

Mailing address

9441 Shadwell Dr
Huntington Beach, CA 92646-7213
Phone (714) 930-5878

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
AT4310CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1477834687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9441 SHADWELL DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467213",
            "telephone_number": "714-930-5878",
            "fax_number": "888-257-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 SHADWELL DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467213",
            "telephone_number": "714-930-5878",
            "fax_number": "888-257-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRISTOVA",
        "first_name": "DANIELA",
        "middle_name": "STOIMENOVA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT4310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.