NPIMap

Organization Active NPI

Pacific Therx

  • Physical Therapy Clinic/Center
  • Portola Valley, CA
National Provider Identifier
1508315300
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
291827 Issued in CA
Legal business name
PACIFIC THERX
Practice address
150 Portola Rd
Suite B
Portola Valley, CA 94028-7852
Phone
(530) 417-7505
NPI assigned
Sep 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Authorized official

Name
Lisa D Green, PTNPI 1528193240
Title
Owner
Phone
(650) 851-1145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 291827 CA Primary

Addresses

Primary practice location

150 Portola Rd
Suite B
Portola Valley, CA 94028-7852

Mailing address

150 Portola Rd
Suite B
Portola Valley, CA 94028-7852

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1508315300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PORTOLA RD",
            "address_2": "SUITE B",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PORTOLA RD",
            "address_2": "SUITE B",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287852",
            "telephone_number": "530-417-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC THERX",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-851-1145",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "291827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.