Individual provider Active NPI

Clea Priscila Tucker, PT

  • Physical Therapist
  • Santa Monica, CA
National Provider Identifier
1780937243
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39033 Issued in CA
Practice address
1821 Wilshire Blvd
Suite 311
Santa Monica, CA 90403-5618
Phone
(310) 453-6166
Fax
(310) 453-6154
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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 39033 CA Primary

Addresses

Primary practice location

1821 Wilshire Blvd
Suite 311
Santa Monica, CA 90403-5618

Mailing address

1821 Wilshire Blvd
Suite 311
Santa Monica, CA 90403-5618
Phone (310) 453-6166

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
39033CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hara/Nelson Physical Therapy Corporation Physical Therapist CurrentSince Nov 7, 2012 Accepting new patients
State-of-the-Art Physical Therapy, Inc. Physical Therapist PastSince Jul 1, 2011 Accepting new patients
Kim M Finklestein Physical Therapy Inc Physical Therapist PastSince Jan 1, 2004 Accepting new patients

Locations

11687 National Blvd
Los Angeles, CA 90064
Phone (310) 481-9965

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392595200000",
    "number": "1780937243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD",
            "address_2": "SUITE 311",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035618",
            "telephone_number": "310-453-6166",
            "fax_number": "310-453-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD",
            "address_2": "SUITE 311",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035618",
            "telephone_number": "310-453-6166",
            "fax_number": "310-453-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CLEA",
        "middle_name": "PRISCILA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2014-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; 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.