Active NPI
Viviana Bonansea
- Physical Therapist
- Manhattan Beach, CA
National Provider Identifier
1548672199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21087
- Practice address
- 1527 21St St
Manhattan Beach, CA 90266-4038 - Phone
- (310) 800-6808
- NPI assigned
- May 29, 2014
- Last updated
- May 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21087 | CA | Primary |
Addresses
Primary practice location
1527 21St St
Manhattan Beach, CA 90266-4038
Mailing address
PO Box 12834
Marina del Rey, CA 90295-3834
Phone (310) 800-6808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14-06213464 | Other | CA | NPA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21087 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401321600000",
"number": "1548672199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12834",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902953834",
"telephone_number": "310-800-6808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1527 21ST ST",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902664038",
"telephone_number": "310-800-6808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONANSEA",
"first_name": "VIVIANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-29",
"last_updated": "2014-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "21087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPA",
"identifier": "14-06213464",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhattan Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.