Provider Demographics
NPI:1568938595
Name:1 TO 1 THERAPIES INC.
Entity Type:Organization
Organization Name:1 TO 1 THERAPIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVISHANKARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHASTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-498-8192
Mailing Address - Street 1:22939 HAWTHORNE BLVD UNIT 303
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3682
Mailing Address - Country:US
Mailing Address - Phone:917-498-8192
Mailing Address - Fax:
Practice Address - Street 1:22939 HAWTHORNE BLVD UNIT 303
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3682
Practice Address - Country:US
Practice Address - Phone:917-498-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251300000XAgenciesLocal Education Agency (LEA)
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========Medicaid