Kimberly Iacobazzi, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

P21655 Issued in NC

Practice address

7812 Edinger Ave Ste 400
Huntington Beach, CA 92647-3727

Phone

(714) 916-0641

NPI assigned

Nov 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Orange County Speech Services

  • Speech-Language Pathologist
  • Huntington Beach, CA
  • NPI 1295000818
  NPD (past)

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1841704384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 LONGFELLOW AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374715",
            "telephone_number": "630-253-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7812 EDINGER AVE STE 400",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473727",
            "telephone_number": "714-916-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOBAZZI",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "293920",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "P21655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Huynh
• Katie Thao Huynh
• Ngan Tuyet Minh Huynh
• Timmy Huynh, PHARMD
• Kelly Hyun
• Julia Johanna Iacobellis, RD
• Claudia Ibarra
• Cynthia Ibarra
• Leslie Ibarra
• David Ibrahim

• Pediatric Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.