Active NPI
Tanjay Marie Castro, P.T.
- Pediatric Physical Therapist
- Lomita, CA
National Provider Identifier
1497070726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 28582
- Practice address
- 24203 Alliene Ave
Lomita, CA 90717-1049 - Phone
- (323) 717-9196
- NPI assigned
- Mar 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 28582 | CA | Primary |
Addresses
Primary practice location
24203 Alliene Ave
Lomita, CA 90717-1049
Mailing address
24203 Alliene Ave
Lomita, CA 90717-1049
Phone (323) 717-9196
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 |
|---|---|---|---|
| 28582 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1497070726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24203 ALLIENE AVE",
"city": "LOMITA",
"state": "CA",
"postal_code": "907171049",
"telephone_number": "323-717-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24203 ALLIENE AVE",
"city": "LOMITA",
"state": "CA",
"postal_code": "907171049",
"telephone_number": "323-717-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO",
"first_name": "TANJAY",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-30",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "28582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lomita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.