Individual provider Active NPI

Amy Wakabayashi Becker, DPT

  • Physical Therapist
  • Montrose, CA
National Provider Identifier
1548586332
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36638 Issued in CA
Practice address
4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520
Phone
(818) 792-5143
NPI assigned
Apr 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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 36638 CA Primary

Addresses

Primary practice location

4105 Ocean View Blvd
Suite a
Montrose, CA 91020-1520

Mailing address

39 Congress St
Suite 303
Pasadena, CA 91105-3024
Phone (858) 414-6552

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
36638CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Polito Physical Therapy, Inc. PastSince Feb 21, 2013 Accepting new patients
Wakabayashi Physical Therapy Inc. Physical Therapist PastSince May 27, 2010 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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1548586332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CONGRESS ST",
            "address_2": "SUITE 303",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053024",
            "telephone_number": "858-414-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 OCEAN VIEW BLVD",
            "address_2": "SUITE A",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201520",
            "telephone_number": "818-792-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "AMY",
        "middle_name": "WAKABAYASHI",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.