Individual provider Active NPI

Michelle T. Reyes-Guerrero, PTA

  • Physical Therapy Assistant
  • Los Angeles, CA
National Provider Identifier
1750405353
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 6890 Issued in CA
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(323) 669-2118
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 6890 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

2070 E Orange Grove Blvd
Pasadena, CA 91104-4803
Phone (626) 298-6197

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

LicenseStateTypeSpecialty
AT 6890CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750405353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 E ORANGE GROVE BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044803",
            "telephone_number": "626-298-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-669-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-GUERRERO",
        "first_name": "MICHELLE",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 6890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.