NICOLE INDART (NPI# 1154787224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154787224 |
| Entity Type | Individual |
| Full Name | NICOLE INDART |
| Practice Address |
3717 Mt Diablo Blvd Suite 100 Lafayette CA 94549-3588 |
| Practice Telephone | 9252845300 |
| Practice Fax Number | 9252845381 |
| Mailing Telephone | 9252845300 |
| Mailing Fax Number | 9252845381 |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT24274 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PT LICENSE | PT24274 | 01 |
| Street Address |
3717 MT DIABLO BLVD SUITE 100 |
| City | LAFAYETTE |
| State | CA |
| Zip Code | 94549-3588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033221551 | Theodore Alan Glattke | Physical Therapist | 3717 Mt Diablo Blvd, Suite100, Lafayette, CA 94549-3588 | 2006-08-31 |
| 1124633060 | Elise Pellett | Physical Therapist | 3717 Mt Diablo Blvd, Lafayette, CA 94549-3588 | 2020-09-08 |
| 1639517907 | Edward Craig Klass | Physical Therapist | 3717 Mt Diablo Blvd, Suite 100, Lafayette, CA 94549-3588 | 2013-06-10 |
| 1275624405 | David Hatae | Physical Therapist | 3717 Mt Diablo Blvd, Suite 100, Lafayette, CA 94549-3588 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427004 | Veronica Adelaid Valera-averilla | Behavior Technician | 3650 Mt Diablo Blvd. Ste. 107, Lafayette Ca Contra, CA 94549 | 2020-11-06 |
| 1679128870 | Zong Ning Zhou | Behavior Technician | 3650 Mt.diablo Blvd., Suite 107, Lafayette, CA 94549 | 2019-08-05 |
| 1912551227 | Tamiesha Jackson | Behavior Technician | Ste Consultant, LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2019-07-25 |
| 1528525375 | Tiara Lajai Aubrey | Behavior Technician | 3560 Mt. Diablo Blvd, Suite 107, Layfatte, CA 94549 | 2019-02-28 |
| 1215409990 | Marisa Della Marmolejo | Case Manager/Care Coordinator | Ste Consultants, LLC 3650 Mt Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-12-19 |
| 1235608399 | Andrew Thompson | Behavior Technician | 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-11-19 |
| 1982172953 | Amber Jackson | Behavior Technician | Ste, LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-11-08 |
| 1104393396 | Alexis Taper | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-10-26 |
| 1023508793 | Alyssa Savinovich | Behavior Technician | 3560 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-05-17 |
| 1831689140 | Kannambra M Raja | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-05-11 |
| Find all providers in zip 94549 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467016428 | Grant Anthony Falcon | Physical Therapist | 2531 Dulles Dr, Lafayette, LA 70506-2660 | 2019-04-25 |
| 1942604731 | Tammy Thrasher | Physical Therapist | 1319 W Baseline Road, Suite 100, Lafayette, CO 80026 | 2014-10-22 |
| 1700132180 | Kurt Roeser | Physical Therapist | 2695 Northpark Dr, Suite 102, Lafayette, CO 80026-3177 | 2012-08-03 |
| 1881890770 | Mary Nesbitt Byrne | Physical Therapist | 1549 Euclid Cir, Lafayette, CO 80026-1249 | 2007-06-26 |
| 1114076874 | Heidi Ananda Ojha | Physical Therapist | 3330 St Marys Rd, Lafayette, CA 94549-5149 | 2007-01-10 |
| 1598386245 | Damon Physical Therapy | Physical Therapist | 156 State Route 15, Lafayette, NJ 07848-2607 | 2020-05-05 |
| 1427696707 | Midori Hiraki-sawyers | Physical Therapist | 1000 W South Boulder Rd, Lafayette, CO 80026-2752 | 2019-12-17 |
| 1477024925 | Aware LLC | Physical Therapist | 3330 St Marys Rd, Lafayette, CA 94549-5149 | 2018-12-10 |
| 1073049383 | Nichole Schmidt | Physical Therapist | 1260 N 17th St, Lafayette, IN 47904-2163 | 2017-05-05 |
| 1144756453 | Kirsten Zambon | Physical Therapist | 1260 N 17th St, Lafayette, IN 47904-2163 | 2017-05-05 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.