Colleen Shea O'Connell, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39207 Issued in CA

Practice address

19510 Ventura Blvd
Suite 106
Tarzana, CA 91356-2969

Phone

(818) 996-1725

Fax

(818) 996-0210

NPI assigned

Jul 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1699020156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 VENTURA BLVD",
            "address_2": "SUITE 106",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562969",
            "telephone_number": "818-996-1725",
            "fax_number": "818-996-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19510 VENTURA BLVD",
            "address_2": "SUITE 106",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913562969",
            "telephone_number": "818-996-1725",
            "fax_number": "818-996-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "COLLEEN",
        "middle_name": "SHEA",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.