Individual provider Active NPI

Christina T Velosoyap, PT

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1821382664
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12904 Issued in CA
Practice address
11021 Brookhurst St
Garden Grove, CA 92840-1001
Phone
(714) 399-1111
Fax
(714) 399-1130
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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 PT12904 CA Primary

Addresses

Primary practice location

11021 Brookhurst St
Garden Grove, CA 92840-1001

Mailing address

12572 Valley View St
Garden Grove, CA 92845-2006
Phone (714) 823-4400

Other identifiers 1

IdentifierTypeStateIssuer
PT12904OtherCAPT LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12904CAMDClinical Psychologist
PT12904CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1821382664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12572 VALLEY VIEW ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452006",
            "telephone_number": "714-823-4400",
            "fax_number": "714-823-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928401001",
            "telephone_number": "714-399-1111",
            "fax_number": "714-399-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELOSOYAP",
        "first_name": "CHRISTINA",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT12904",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.