Individual provider Active NPI

Tara Ann Hakala, M.P.T.

  • Physical Therapist
  • Los Alamitos, CA
National Provider Identifier
1710002928
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26600 Issued in CA
Practice address
11462 Kensington Rd
Los Alamitos, CA 90720-3804
Phone
(562) 400-8250
NPI assigned
Mar 20, 2007
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 26600 CA Primary

Addresses

Primary practice location

11462 Kensington Rd
Los Alamitos, CA 90720-3804

Mailing address

6444 E Spring St Ste 641
Long Beach, CA 90815-1553
Phone (562) 400-8250

Other names 1

  • Ms. Tara Ann Hansen Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
26600CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1710002928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 E SPRING ST STE 641",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151553",
            "telephone_number": "562-400-8250",
            "fax_number": "562-286-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11462 KENSINGTON RD",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203804",
            "telephone_number": "562-400-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKALA",
        "first_name": "TARA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HANSEN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "M.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.