Vanessa Bautista, AT
Individual provider Active NPI Physical Therapy Assistant · Chatsworth, CA
NPI 1962096164 · NPPES record last updated Feb 27, 2021
Key facts
- NPI
- 1962096164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA8870 (CA)
- Practice address
- 10400 Canoga Ave Apt 201
Chatsworth, CA 91311-2293 - Phone
- (818) 441-9911
- NPI assigned
- Feb 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA8870 | CA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA8870 | CA | Yes |
Addresses
Primary practice location
10400 Canoga Ave Apt 201
Chatsworth, CA 91311-2293
Mailing address
10400 Canoga Ave Apt 201
Chatsworth, CA 91311-2293
Phone (818) 441-9911
Other providers in Chatsworth, CA
- Inna Barg
- Jessica Barragan
- Brayan Alberto Barron
- Richard James Bartley
- Cheryl Ann Batres
- Beachwood Home Health
- Beacon Homecare LLC
- Steven Michael Beard Jr.
- Cassandra Beauvoir
- Isata Adama Beckett
All providers in Chatsworth, CA · Physical Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.