Active NPI
Xandee Lu
- Physical Therapy Assistant
- Glendale, CA
National Provider Identifier
1639787732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10306
- Practice address
- 630 W Broadway
Glendale, CA 91204-1008 - Phone
- (818) 247-3395
- NPI assigned
- Jul 15, 2020
- 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 Therapy Assistant | 225200000X | 10306 | CA | Primary |
Addresses
Primary practice location
630 W Broadway
Glendale, CA 91204-1008
Mailing address
138 S Adams St Apt 5
Glendale, CA 91205-1378
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10306 | Other | CA | PTA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1639787732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 S ADAMS ST APT 5",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912051378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 W BROADWAY",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912041008",
"telephone_number": "818-247-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "XANDEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-15",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "10306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA",
"identifier": "10306",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.