1558498337 NPI number — WESTLAKE PHYSICAL THERAPY, INC.

Table of content: MRS. JULIE MARIE CARPENTER DPT (NPI 1033388657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558498337 NPI number — WESTLAKE PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTLAKE PHYSICAL THERAPY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558498337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 LA VENTA DR
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
WESTLAKE VILLAGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91361-3703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-777-7370
Provider Business Mailing Address Fax Number:
805-777-7380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 JENSEN CT
Provider Second Line Business Practice Location Address:
SUITE 2C
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360-7483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-413-1070
Provider Business Practice Location Address Fax Number:
805-413-1076
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VASQUEZ
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
CARMEN
Authorized Official Title or Position:
P.T., OWNER, SECRETARY & TREASURER
Authorized Official Telephone Number:
805-777-7370

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1043236078 . This is a "PRIMARY GROUP NPI #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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