Stacy Libenson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39770 Issued in CA

Practice address

24825 Embajadores LN
Mission Viejo, CA 92691-5220

Phone

(949) 413-6434

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1649692237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24825 EMBAJADORES LN",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915220",
            "telephone_number": "949-413-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24825 EMBAJADORES LN",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915220",
            "telephone_number": "949-413-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBENSON",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39770",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "39770",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "39770",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lewis
• Mary Li
• Ming Charles Li, MD
• Jenny L Liang, D.M.D
• Shannon Lauren Liauw, FNP-C
• Joshua Jordan Licitra
• Life Vessel Treatment and Recovery
• Life Vessel Treatment and Recovery Driza, LLC
• Andrew Lin, PT
• Andrew Ta Lin, LVN

• Physical Therapist in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.

Verify at the official NPI Registry.