Kimberly Shibuya, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39578 Issued in CA

Practice address

23121 Antonio Pkwy
Suite 100
Rancho Santa Margarita, CA 92688-2658

Phone

(949) 713-6445

Fax

(949) 713-6488

NPI assigned

Nov 15, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1861736845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23121 ANTONIO PKWY",
            "address_2": "SUITE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882658",
            "telephone_number": "949-713-6445",
            "fax_number": "949-713-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23121 ANTONIO PKWY",
            "address_2": "SUITE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882658",
            "telephone_number": "949-713-6445",
            "fax_number": "949-713-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIBUYA",
        "first_name": "KIMBERLY",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT39578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, 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 13, 2019; 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.