Sunjin Wallerstedt

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160030989 Issued in WA

Practice address

3201 Cherry Ridge St Ste D400
San Antonio, TX 78230

Phone

(210) 692-0222

NPI assigned

Nov 7, 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

Other names 1

• Sunjin Lyou Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1912251356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 POSSUM PATH",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 CHERRY RIDGE ST STE D400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78230",
            "telephone_number": "210-692-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLERSTEDT",
        "first_name": "SUNJIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160030989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUNJIN",
            "last_name": "LYOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara Wallace
• Tim Wallace
• Yvette M Wallace, PT
• Amy Matson Walldren, LMSW
• Cal Wallerstedt
• Kelsey B Wallin
• Kristen Jennifer Walling, PA-C
• Victoria Taylor Walling, DDS
• Jessica Wallingsford, LCDC
• Madison Wallingsford

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.