Individual provider Active NPI

Tina Stephen, PT

  • Orthopedic Physical Therapist
  • Ventura, CA
National Provider Identifier
1619082278
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 29053 Issued in CA
Practice address
3525 Loma Vista Rd
Ventura, CA 93003-3101
Phone
(805) 641-6415
Fax
(805) 641-6424
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 29053 CA Primary

Addresses

Primary practice location

3525 Loma Vista Rd
Ventura, CA 93003-3101

Mailing address

3525 Loma Vista Rd
Ventura, CA 93003-3101
Phone (805) 641-6415

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
PT 29053CAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1619082278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033101",
            "telephone_number": "805-641-6415",
            "fax_number": "805-641-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033101",
            "telephone_number": "805-641-6415",
            "fax_number": "805-641-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "TINA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 29053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

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