Individual provider Active NPI

Shanell Noji, PTA

  • Physical Therapy Assistant
  • Laguna Niguel, CA
National Provider Identifier
1912416595
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA10644 Issued in CA
Practice address
30025 Alicia Pkwy Ste G-262
Laguna Niguel, CA 92677-2090
Phone
(714) 281-0169
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA10644 CA Primary

Addresses

Primary practice location

30025 Alicia Pkwy Ste G-262
Laguna Niguel, CA 92677-2090

Mailing address

PO Box 2298
Orange, CA 92859-0298

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA10644CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1912416595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2298",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928590298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30025 ALICIA PKWY STE G-262",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772090",
            "telephone_number": "714-281-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOJI",
        "first_name": "SHANELL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA10644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.