Organization Active NPI

Embody Yoga & Physical Therapy Centers Inc

  • Physical Therapist
  • La Jolla, CA
National Provider Identifier
1669648481
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13530 Issued in CA
Legal business name
EMBODY YOGA & PHYSICAL THERAPY CENTERS INC
Practice address
5632 La Jolla Blvd
La Jolla, CA 92037
Phone
(858) 454-9355
Fax
(858) 454-9305
NPI assigned
May 1, 2008
Organization subpart
Yes
Parent organization
EMBODY YOGA & PHYSICAL THERAPY CENTERS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Ms. Diana Jean Smith, MS PTNPI 1083948418
Title
Owner Secretary
Phone
(858) 454-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT13530 CA Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT23105 CA

Addresses

Primary practice location

5632 La Jolla Blvd
La Jolla, CA 92037

Mailing address

5632 La Jolla Blvd
La Jolla, CA 92037
Phone (858) 454-9355

National Provider Directory

National Provider Directory
Part of
Embody Yoga Phys Therapy

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1669648481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5632 LA JOLLA BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-454-9355",
            "fax_number": "858-454-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 LA JOLLA BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-454-9355",
            "fax_number": "858-454-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODY YOGA & PHYSICAL THERAPY CENTERS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMBODY YOGA & PHYSICAL THERAPY CENTERS INC",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER SECRETARY",
        "authorized_official_telephone_number": "858-454-9355",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13530",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.