Our Lady of Providence Physical Therapy Clinic

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT 18580 Issued in CA

Legal business name

OUR LADY OF PROVIDENCE PHYSICAL THERAPY CLINIC

Practice address

10843 Magnolia Blvd Ste 2
North Hollywood, CA 91601-3922

Phone

(818) 506-4119

Fax

(818) 506-8115

NPI assigned

Jul 9, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Marcelle Deaibes, R.P.TNPI 1528140027

Title

President/Director

Phone

(818) 506-4119

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Marcelle Deaibes, R.P.T

  • Physical Therapist
  • North Hollywood, CA
  • NPI 1528140027
  NPD (past) Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548293780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10843 MAGNOLIA BLVD STE 2",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013922",
            "telephone_number": "818-506-4119",
            "fax_number": "818-506-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10843 MAGNOLIA BLVD STE 2",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013922",
            "telephone_number": "818-506-4119",
            "fax_number": "818-506-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF PROVIDENCE PHYSICAL THERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAIBES",
        "authorized_official_first_name": "MARCELLE",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "818-506-4119",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.P.T"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT 18580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "ZZZ08154Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Carolyn Ortiz
• Kaobimdi C Osamor
• Karen V Osburn, CMT, LMT
• Osher Resources Inc (Act Medical Group Inc)
• Diana June Osterhues, D.P.T.
• Our Lady of Providence PT Clinic
• Outpatient Hospice Care, Inc.
• Elysia Yi Ouyang
• Victoria Vicky Ovakyan, NP
• Oval Physical Therapy and Sports Medicine, Inc.

• Physical Therapy Clinic/Center in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Physical Therapy Clinic/Center in California

• 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.