Active NPI
Phyll Ayn Valencia
- Physical Therapy Assistant
- Winnetka, CA
National Provider Identifier
1699164921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8094
- Practice address
- 8125 Hatillo Ave
Winnetka, CA 91306-1909 - Phone
- (818) 300-9710
- NPI assigned
- Jan 9, 2015
- Last updated
- Jan 9, 2015
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 8094 | CA | Primary |
Addresses
Primary practice location
8125 Hatillo Ave
Winnetka, CA 91306-1909
Mailing address
8125 Hatillo Ave
Winnetka, CA 91306
Phone (818) 300-9710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8094 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420761600000",
"number": "1699164921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8125 HATILLO AVE",
"city": "WINNETKA",
"state": "CA",
"postal_code": "91306",
"telephone_number": "818-300-9710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8125 HATILLO AVE",
"city": "WINNETKA",
"state": "CA",
"postal_code": "913061909",
"telephone_number": "818-300-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENCIA",
"first_name": "PHYLL AYN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-09",
"last_updated": "2015-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "8094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnetka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.