Healthcare Provider Details

I. General information

NPI: 1962326769
Provider Name (Legal Business Name): ANNA VOGT PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E FOOTHILL BLVD STE 100
ARCADIA CA
91006-2600
US

IV. Provider business mailing address

8124 SW PINE ST
PORTLAND OR
97223-8777
US

V. Phone/Fax

Practice location:
  • Phone: 626-275-6302
  • Fax:
Mailing address:
  • Phone: 503-707-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number55068
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: