Vagner Carvalho Dachao, PTA, OPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4396 Issued in MD

Practice address

1201 E Ocean Ave
Lompoc, CA 93436-7081

Phone

(805) 735-8365

NPI assigned

Sep 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Performance Physical Therapy and Rehabilitation, Inc

  • Physical Therapist
  • Lompoc, CA
  • NPI 1720023658
  NPD (past)

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1720638646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9642 WASHINGTON AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231870",
            "telephone_number": "301-300-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E OCEAN AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367081",
            "telephone_number": "805-735-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACHAO",
        "first_name": "VAGNER",
        "middle_name": "CARVALHO",
        "name_prefix": "Mr.",
        "credential": "PTA, OPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49677",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2142830",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Scandalis Cross, MA CCC
• David Crouch, M.F.T.
• Jessica L Cumber, PHARMD
• Melissa Ann Cummings, PT
• Christopher George Czajka, D.C.
• Deborah Daily
• Dale Ekstrum MD Inc
• Dane Dudley DDS Inc.
• Jeffrey Lynn Danhauer, PH.D.
• Daniel R. Taketa

• Physical Therapy Assistant in Lompoc, CA
• Providers in Lompoc, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.