Active NPI
Anne-Marie Beaulieu, P.T.A.
- Physical Therapy Assistant
- Cerritos, CA
National Provider Identifier
1487094611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9075
- Practice address
- 12729 Andy St
Cerritos, CA 90703-6044 - Phone
- (508) 330-6574
- NPI assigned
- Jul 2, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9075 | CA | Primary |
| Physical Therapy Assistant | 225200000X | 2068 | MA |
Addresses
Primary practice location
12729 Andy St
Cerritos, CA 90703-6044
Mailing address
12729 Andy St
Cerritos, CA 90703-6044
Phone (508) 248-6865
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 |
|---|---|---|---|
| 9075 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372723200000",
"number": "1487094611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12729 ANDY ST",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036044",
"telephone_number": "508-248-6865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12729 ANDY ST",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036044",
"telephone_number": "508-330-6574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAULIEU",
"first_name": "ANNE-MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-02",
"last_updated": "2013-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "9075",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "2068",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.