NPIMap

Organization Active NPI

Catch a Wave Physical Therapy

Doing business as San Clemente Physical Therapy

  • Physical Therapist
  • San Clemente, CA
National Provider Identifier
1679082085
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36685 Issued in CA
Legal business name
CATCH A WAVE PHYSICAL THERAPY
Doing business as
San Clemente Physical Therapy
Practice address
647 Camino de Los Mares Ste 111
San Clemente, CA 92673-2806
Phone
(949) 240-0600
Fax
(949) 240-7578
NPI assigned
Sep 28, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Holly K Finley, PTNPI 1053539197
Title
President
Phone
(949) 240-0600

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 36685 CA Primary

Addresses

Primary practice location

647 Camino de Los Mares Ste 111
San Clemente, CA 92673-2806

Mailing address

647 Camino de Los Mares Ste 111
San Clemente, CA 92673-2806
Phone (949) 240-0600

Other names 1

  • San Clemente Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180126000274 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234498916 Receives reassigned benefits from 3 practitioners
Practice locations: San Clemente, CA

National Provider Directory

National Provider Directory

Locations

647 Camino de los Mares
Ste 108147
San Clemente, CA 92673

647 Camino de los Mares
Ste 111
San Clemente, CA 92673
Phone (949) 240-0600

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679082085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 CAMINO DE LOS MARES STE 111",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732806",
            "telephone_number": "949-240-0600",
            "fax_number": "949-240-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 CAMINO DE LOS MARES STE 111",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732806",
            "telephone_number": "949-240-0600",
            "fax_number": "949-240-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATCH A WAVE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-240-0600",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Clemente Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.