Individual provider Active NPI

Yana Cheatham

  • Physical Therapist
  • San Pedro, CA
National Provider Identifier
1639884455
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303359 Issued in CA
Practice address
481 W 6TH St
San Pedro, CA 90731-2631
Phone
(424) 536-3023
Fax
(424) 536-3093
NPI assigned
Jan 16, 2023
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 303359 CA Primary

Addresses

Primary practice location

481 W 6TH St
San Pedro, CA 90731-2631

Mailing address

481 W 6TH St
San Pedro, CA 90731-2631
Phone (424) 536-3023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230202001154 CA Practitioner - Physical Therapist in Private Practice 7315319241 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303359CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Physical Therapy & Coast Rehab Physical Therapist CurrentSince Dec 6, 2022 Accepting new patients
Physical Therapy San Pedro Corp. Physical Therapist CurrentSince Apr 9, 2024 Accepting new patients
Patriot Physical Therapy Inc Physical Therapist CurrentSince Dec 6, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Aug 9, 2024 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

28901 S Western Ave
Ste 103
Rancho Palos Verdes, CA 90275
Phone (310) 732-0036

481 W 6th St
San Pedro, CA 90731
Phone (424) 536-3023

415 W 6th St
San Pedro, CA 90731
Phone (424) 536-3023

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1639884455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312631",
            "telephone_number": "424-536-3023",
            "fax_number": "424-536-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312631",
            "telephone_number": "424-536-3023",
            "fax_number": "424-536-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "YANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.