Bettina Kathleen Shockley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT23022 Issued in CA

Practice address

26357 McBean Pkwy
Ste 220
Santa Clarita, CA 91355

Phone

(661) 254-0077

Fax

(661) 254-2788

NPI assigned

Nov 10, 2005

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1700867157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 VENTURA BLVD",
            "address_2": "STE 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": "26357 MCBEAN PKWY",
            "address_2": "STE 220",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "661-254-0077",
            "fax_number": "661-254-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "BETTINA",
        "middle_name": "KATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry M Sherman, M.D.
• Travis L Shiba
• Desirae Morgan Shields
• Junseok Shim, AUD
• Vaheh Shirvanian, M.D.
• Maclain Everett Shumway
• Dara Siassi, DOCTOR OF PHARMACY
• Lesly Vanessa Sibrian
• Carol Sida, ASW138035
• Sierra Medical Supply Inc.

• Physical Therapist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.