Deanna Antoinette Ductoc, MS, ATC, CEAS

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

2000011238 Issued in CA

Practice address

8625 Woodman Ave
Arleta, CA 91331-6504

Phone

(213) 200-0355

NPI assigned

Oct 7, 2022

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1891410221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 MIDWICKHILL DR",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918034510",
            "telephone_number": "626-487-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 WOODMAN AVE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913316504",
            "telephone_number": "213-200-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCTOC",
        "first_name": "DEANNA",
        "middle_name": "ANTOINETTE",
        "credential": "MS, ATC, CEAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "2000011238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "dductoc@pivoths.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8625 Woodman Ave",
            "city": "Arleta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913316504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Arleta, CA
• Providers in Arleta, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.