OUR LADY OF PROVIDENCE PHYSICAL THERAPY CLINIC (NPI# 1548293780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548293780 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF PROVIDENCE PHYSICAL THERAPY CLINIC |
| Practice Address |
10843 Magnolia Blvd Ste 2 North Hollywood CA 91601-3922 |
| Practice Telephone | 8185064119 |
| Practice Fax Number | 8185068115 |
| Mailing Telephone | 8185064119 |
| Mailing Fax Number | 8185068115 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARCELLE DEAIBES (PRESIDENT/DIRECTOR) |
| Authorized Official Telephone | 8185064119 |
| Authorized Official Credential | R.P.T |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT 18580 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHYSICAL THERAPY | ZZZ08154Z | 01 |
| Street Address |
10843 MAGNOLIA BLVD STE 2 |
| City | NORTH HOLLYWOOD |
| State | CA |
| Zip Code | 91601-3922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528140027 | Marcelle Deaibes | Physical Therapist | 10843 Magnolia Blvd Ste 2, North Hollywood, CA 91601-3922 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942711825 | Geoffrey Ryan | Counselor | 5002 Tujunga Ave. #303, North Hollywood, CA 91601 | 2017-10-18 |
| 1508305772 | Melody Zara | Acupuncturist | 5257 Vineland Ave., North Hollywood, CA 91601 | 2017-02-21 |
| 1013455500 | Chandler Treatment LLC | Preferred Provider Organization | 5503 Cahuenga Blvd Suite 201, Northhollywood, CA 91601 | 2017-02-06 |
| 1770021230 | Bairat Shasi | Nurse Practitioner | 5251 Vineland Ave Apt 514, North Hollywood, CA 91601 | 2017-02-05 |
| 1194187609 | A&m Miracle Home Health Care, Inc | Home Health | 10545 Burbank Blvd., Suite 127, North Hollywood, CA 91601 | 2016-03-23 |
| 1053771329 | Suzette Galvez | Case Manager/Care Coordinator | 11415 Albers St Apt 4, Noho, CA 91601 | 2016-03-01 |
| 1467835025 | Loyalty Home Health, Inc. | Home Health | 10545 Burbank Blvd Suite 117, North Hollywood, CA 91601 | 2015-07-01 |
| 1689063646 | Jane Edith Wilson | Counselor | 11027 Bubank Blvd, North Hollywood, CA 91601 | 2015-01-14 |
| 1083022206 | Mulberry Leaf Acupuncture & Herbs | Acupuncturist | 5257 Vineland Ave, North Hollywood, CA 91601 | 2014-07-31 |
| 1306256813 | Confidence & Care Hospice, Inc. | Hospice Care, Community Based | 10523 Burbank Blvd Suite 221, North Hiollywood, CA 91601 | 2014-05-06 |
| Find all providers in zip 91601 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487184982 | Comfort Care Physical Therapy, Inc. | Clinic/Center | 11755 Victory Blvd Ste 104, North Hollywood, CA 91606-3462 | 2017-06-15 |
| 1962895805 | Jam Sports Inc | Clinic/Center | 12813 Victory Blvd, North Hollywood, CA 91606 | 2015-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051839 | The Pelvic Model Physical Therapy, Inc. | Clinic/Center | 3761 Vinton Ave Apt 6, Los Angeles, CA 90034-5781 | 2020-10-18 |
| 1932707957 | Body In Motion Therapy, P.c | Clinic/Center | 1111 S Grand Ave Apt 708, Los Angeles, CA 90015-2169 | 2020-10-12 |
| 1992303275 | Vw Physical Therapy, Inc. | Clinic/Center | 100 Saybrook Ave, Vacaville, CA 95687-4129 | 2020-10-09 |
| 1730787094 | Movement System Institute Physiotherapy Inc | Clinic/Center | 508 Glenwood Rd Apt 102, Glendale, CA 91202-1572 | 2020-10-09 |
| 1538766530 | Sterling King Physical Therapy | Clinic/Center | 1820 Fullerton Ave Ste 280, Corona, CA 92881-3175 | 2020-10-03 |
| 1902403041 | Jha Geriatric Services, Inc | Clinic/Center | 12490 Fielding Circle, Suite 174, Playa Vista, CA 90094-3024 | 2020-10-01 |
| 1245847540 | Bespoke San Diego Physical Therapy PC | Clinic/Center | 2748 Ariane Dr, Unit 141, San Diego, CA 92117-3407 | 2020-09-30 |
| 1285241786 | Rapid Recovery Physical Therapy Inc | Clinic/Center | 39807 Paseo Padre Pkwy, Fremont, CA 94538-2974 | 2020-09-28 |
| 1053928697 | Bonnie Laine Lasher | Clinic/Center | 33772 Copper Lantern St Apt C, Dana Point, CA 92629-6427 | 2020-09-28 |
| 1295340792 | Naum Physical Therapy PC | Clinic/Center | 11405 Fulbourn Ct, Rancho Cucamonga, CA 91730-8341 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | NORTH HOLLYWOOD |
| Zip Code | 91601 |
Please comment or provide details below to improve the information on OUR LADY OF PROVIDENCE PHYSICAL THERAPY CLINIC.
| 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.