Shaka Surf Club

Primary specialty

Recreation TherapistTaxonomy code 225800000X

Legal business name

SHAKA SURF CLUB

Practice address

26565 Agoura Rd Ste 200
Calabasas, CA 91302-1990

Phone

(818) 584-6290

Fax

(888) 222-1042

NPI assigned

Aug 22, 2022

Organization subpart

No

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

Authorized official

Name

Rose Salinas

Title

Co-Owner

Phone

(818) 584-6290

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1902525124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26565 AGOURA RD STE 200",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021990",
            "telephone_number": "818-584-6290",
            "fax_number": "888-222-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26565 AGOURA RD STE 200",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021990",
            "telephone_number": "818-584-6290",
            "fax_number": "888-222-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKA SURF CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "SALINAS",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "818-584-6290"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Recreation Therapist in Calabasas, CA
• Providers in Calabasas, CA by specialty
• Recreation Therapist in California

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