Individual provider Active NPI

Venita Lovelace-Chandler, PHD, PT, PCS

  • Physical Therapist
  • Tustin, CA
National Provider Identifier
1508918004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28791 Issued in CA
Practice address
250 El Camino Real
Suite 100
Tustin, CA 92780-3655
Phone
(714) 838-6999
Fax
(714) 838-7099
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28791 CA Primary

Addresses

Primary practice location

250 El Camino Real
Suite 100
Tustin, CA 92780-3655

Mailing address

250 El Camino Real
Suite 100
Tustin, CA 92780-3655
Phone (714) 838-6999

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PT28791CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Physical Therapy, Apc Physical Therapist PastSince Jul 1, 2004 Accepting new patients
HW Physical Therapy Physical Therapist PastSince Jun 1, 2018 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508918004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 EL CAMINO REAL",
            "address_2": "SUITE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803655",
            "telephone_number": "714-838-6999",
            "fax_number": "714-838-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 EL CAMINO REAL",
            "address_2": "SUITE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803655",
            "telephone_number": "714-838-6999",
            "fax_number": "714-838-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE-CHANDLER",
        "first_name": "VENITA",
        "name_prefix": "Mrs.",
        "credential": "PHD, PT, PCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.