Active NPI
Rose Avila, P.T.
- Physical Therapist
- Rancho Mirage, CA
National Provider Identifier
1932321825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 24319
- Practice address
- 72201 Country Club Drive
Brighton Gardens
Rancho Mirage, CA 92270 - Phone
- (760) 340-5999
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 24319 | CA | Primary |
Addresses
Primary practice location
72201 Country Club Drive
Brighton Gardens
Rancho Mirage, CA 92270
Mailing address
3639 Paris Street
Hemet, CA 92545-6323
Phone (951) 925-5048
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 24319 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932321825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3639 PARIS STREET",
"city": "HEMET",
"state": "CA",
"postal_code": "925456323",
"telephone_number": "951-925-5048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72201 COUNTRY CLUB DRIVE",
"address_2": "BRIGHTON GARDENS",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "92270",
"telephone_number": "760-340-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVILA",
"first_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 24319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.