Physiotherapy Associates, Inc.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

PHYSIOTHERAPY ASSOCIATES, INC.

Doing business as

Select Physical Therapy

Practice address

320 Tesconi Cir Ste G
Santa Rosa, CA 95401-4611

Phone

(707) 544-2647

Fax

(707) 544-2088

NPI assigned

Jan 17, 2020

Organization subpart

Yes

Parent organization

SELECT MEDICALAs reported in NPPES

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

Authorized official

Name

Michael Tarvin

Title

Vice President

Phone

(717) 972-1100

Specialties & licenses 2

Addresses

Other names 1

• Select Physical Therapy Doing business as

Part of

Select Medical Corporation

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1821628991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 TESCONI CIR STE G",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014611",
            "telephone_number": "707-544-2647",
            "fax_number": "707-544-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOTHERAPY ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Select Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayli Khamvanh Phommavongsa
• Esamou Phongsa-Chu, FNP
• Jenny Phung
• Physiotherapy Associates Inc
• Physiotherapy Associates Inc
• Kimberly Quan Pia, MFT TRAINEE
• Jessica Lynn Piazza, L.AC.
• Marie Frances Piazza, MFT
• Winnie Piccolo
• Dominic Joseph Picetti, MD

• Occupational Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.