Organization Active NPI

Gary Colletto PT

Doing business as Colletto Physical Therapy

  • Physical Therapist
  • Granada Hills, CA
National Provider Identifier
1508986233
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7597 Issued in CA
Legal business name
GARY COLLETTO PT
Doing business as
Colletto Physical Therapy
Practice address
10605 Balboa Blvd
#240
Granada Hills, CA 91344-6342
Phone
(818) 366-3935
Fax
(818) 368-9351
NPI assigned
Mar 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Katherine Prentice, PT
Title
PT
Phone
(818) 366-3935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT7597 CA Primary

Addresses

Primary practice location

10605 Balboa Blvd
#240
Granada Hills, CA 91344-6342

Mailing address

16692 Knollwood Dr
Granada Hills, CA 91344-2621
Phone (818) 366-3935

Other names 1

  • Colletto Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508986233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16692 KNOLLWOOD DR",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442621",
            "telephone_number": "818-366-3935",
            "fax_number": "818-368-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 BALBOA BLVD",
            "address_2": "#240",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446342",
            "telephone_number": "818-366-3935",
            "fax_number": "818-368-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY COLLETTO PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "818-366-3935",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT7597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colletto Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.