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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BUENAVENTURA GAVIOLA AGRAVIADOR III, PTLA

Deactivated Sole Proprietor

BUENAVENTURA GAVIOLA AGRAVIADOR III, PTLA is a Physical Therapy Assistant healthcare provider located in NORTHRIDGE, California. NPI 1366116170 is deactivated in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · NORTHRIDGE, CA

This NPI has been deactivated. The record was deactivated on February 21, 2023. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1366116170
Provider Type
Individual
Gender
Male
NPI Issued
Aug 4, 2021 (1.5506849315068 yrs)
Last Updated
Aug 4, 2023
Deactivated
Feb 21, 2023
License
PTLA (CA)
Sole Proprietor
Yes

Practice Information

Address
18709 FRANKFORT ST
NORTHRIDGE, CA, 913244523
Browse CA providers · Browse ZIP 91324
Phone
8183589992
Primary Specialty
Physical Therapy Assistant
225100000X

Other Physical Therapy Assistant Providers in NORTHRIDGE, CA

Name Credential NPI
ANNE KATZ PT 1215974324
RICHARD KATZ PT 1477590438
LAWRENCE CUMMINGS PT 1942247911
DR. JAINA BHAGAT PATEL DPT 1619083045
VANESSA KURATA FINLEY MPT 1770669186
MR. KAVEH SHOKOOHI SOODJANI P.T. 1508929043
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.