Individual provider Active NPI

Laura Joanne Ulyate, MPT

  • Physical Therapist
  • Lake Forest, CA
National Provider Identifier
1902171200
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 38767 Issued in CA
Practice address
20382 Barents Sea Cir
Lake Forest, CA 92630-8807
Phone
(949) 292-3068
NPI assigned
Mar 20, 2012
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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 PT 38767 CA Primary

Addresses

Primary practice location

20382 Barents Sea Cir
Lake Forest, CA 92630-8807

Mailing address

28241 Crown Valley Pkwy
Ste F321
Laguna Niguel, CA 92677-4441
Phone (949) 292-3068

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
PT 38767CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rausch Physical Therapy, Inc. Physical Therapist CurrentSince Dec 11, 2017 Accepting new patients
Pack Physical Therapy Past Accepting new patients

Locations

24582 Del Prado
Ste C
Dana Point, CA 92629
Phone (949) 276-5401

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1902171200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28241 CROWN VALLEY PKWY",
            "address_2": "STE F321",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774441",
            "telephone_number": "949-292-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20382 BARENTS SEA CIR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308807",
            "telephone_number": "949-292-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULYATE",
        "first_name": "LAURA",
        "middle_name": "JOANNE",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 38767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.