Active NPI
Yvonne Kathleen Calderon, DPT
- Physical Therapist
- Thousand Oaks, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 294730
- Practice address
- 2230 Lynn Rd Ste 250
Thousand Oaks, CA 91360-1975 - Phone
- (805) 379-2132
- Fax
- (805) 917-4206
- NPI assigned
- Aug 21, 2017
- 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 Therapist | 225100000X | 294730 | CA | Primary |
Addresses
Primary practice location
2230 Lynn Rd Ste 250
Thousand Oaks, CA 91360-1975
Mailing address
5720 Ralston St Ste 200
Ventura, CA 93003-7844
Phone (805) 804-4168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 294730 | Other | CA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, AZ
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
555 N Bash St
El Segundo, CA 90245-2818
Phone (310) 666-9003
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 294730 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Function for Life Physical Therapy, Inc. | Physical Therapist | Current | Accepting new patients |
| Arizona Luna Care Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362
9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298
555 N Nash St
El Segundo, CA 90245
Phone (310) 386-6788
1084 N El Camino Real
#B351
Encinitas, CA 92024
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Carlsbad, CA
- NPI 1568767309
-
- Physical Therapist
- Peoria, AZ
- NPI 1629698147
-
- Sports Physical Therapist
- Moorpark, CA
- NPI 1861664377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1679099790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 RALSTON ST STE 200",
"city": "VENTURA",
"state": "CA",
"postal_code": "930037844",
"telephone_number": "805-804-4168",
"fax_number": "805-830-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 LYNN RD STE 250",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913601975",
"telephone_number": "805-379-2132",
"fax_number": "805-917-4206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "YVONNE",
"middle_name": "KATHLEEN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-21",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "294730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "294730",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.