Individual provider Active NPI

Danielle Shabbouei

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1881432433
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8046643 Issued in CA
Practice address
11611 San Vicente Blvd
Los Angeles, CA 90049-5106
Phone
(925) 430-6630
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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 8046643 CA Primary

Addresses

Primary practice location

11611 San Vicente Blvd
Los Angeles, CA 90049-5106

Mailing address

474 Arbramar Ave
Pacific Palisades, CA 90272-4213
Phone (310) 569-3315

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
8046643CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists Inc Physical Therapist CurrentSince Nov 12, 2024 Accepting new patients
W. Seth Bolling, MD, Inc PastSince Nov 12, 2024 Accepting new patients

Locations

200 N Robertson Blvd
Ste 301
Beverly Hills, CA 90211
Phone (310) 273-7800

6310 San Vicente Blvd
Ste 200
Los Angeles, CA 90048
Phone (310) 273-7800

Organizations & group practices 2

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": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1881432433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 ARBRAMAR AVE",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724213",
            "telephone_number": "310-569-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11611 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495106",
            "telephone_number": "925-430-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABBOUEI",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "8046643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.