Citrus Valley Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CITRUS VALLEY PHYSICAL THERAPY INC

Doing business as

Citrus Valley Physical Therapy and Wellness Center

Practice address

2079 Orange Tree LN
Redlands, CA 92374-2849

Phone

(909) 435-5729

NPI assigned

Aug 27, 2021

Last updated

Mar 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent WildNPI 1346638707

Title

Owner

Phone

(909) 435-5729

Specialties & licenses 1

Addresses

Other names 1

• Citrus Valley Physical Therapy and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Wild, DPT

  • Physical Therapist
  • Redlands, CA
  • NPI 1346638707
  Medicare reassignment Care Compare group NPD Authorized official
• Nicolas Robert Escobar, PT, DPT

  • Physical Therapist
  • Redlands, CA
  • NPI 1457231995
  Medicare reassignment Care Compare group NPD
• Hannah Lynn Goerke

  • Physical Therapist
  • Redlands, CA
  • NPI 1669344032
  Medicare reassignment Care Compare group NPD
• Raymond Phillip Ruiz, PT, DPT

  • Physical Therapist
  • Corona, CA
  • NPI 1851047914
  Medicare reassignment Care Compare group NPD
• Hayley Park, DPT

  • Physical Therapist
  • Middletown, DE
  • NPI 1336878453

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1740957521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 ORANGE TREE LN",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742849",
            "telephone_number": "909-435-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 ORANGE TREE LN",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742849",
            "telephone_number": "909-435-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS VALLEY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-435-5729"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Valley Physical Therapy and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Citrus Valley Physical Therapy and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan A Cintron, SLPA
• Antonia Ciovica, PH.D.
• Citrus Counseling Services, Inc
• Citrus Counseling Services, Inc
• Citrus Valley Imaging, Inc
• City of Redlands
• Clarivolve Mental Health Nursing PC
• Christopher Michael Clark, P.A-C
• Leonette Clayson, CNM, FNP
• Clear View Behavioral Services

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.