Andrew Latta, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

305931 Issued in CA

Practice address

735 W Channel Islands Blvd
Port Hueneme, CA 93041-2130

Phone

(805) 250-7505

NPI assigned

Jul 25, 2019

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Male

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

Enrolled in AZ, CA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Second Wave Physical Therapy IncGroup PAC ID 3274996905, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Second Wave Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Oxnard, CA
  • NPI 1851082812

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Giardina Sportsmedicine Consultants, Inc.

  dba Total Sports Therapy

  • Physical Therapy Clinic/Center
  • Cave Creek, AZ
  • NPI 1013125483

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1780238915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606276",
            "telephone_number": "480-551-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 W CHANNEL ISLANDS BLVD",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412130",
            "telephone_number": "805-250-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTA",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• L M Rivas DMD, Inc.
• Nathan Lai, DDS
• Pauline Lai, PHARM.D.
• Tina Lai
• Charlotte Lamb
• Blanca Estela Lemus
• Jason Lim, LCSW
• Longs Drug Stores California LLC (CVS Pharmacy #09286)
• Adrian Elenes Lopez
• Merle Gene Lopez Jr., PT

• Physical Therapist in Port Hueneme, CA
• Providers in Port Hueneme, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.