Healthcare Provider Details

I. General information

NPI: 1568938595
Provider Name (Legal Business Name): 1 TO 1 THERAPIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5719 E GOSSAMER ST
LONG BEACH CA
90808-2713
US

IV. Provider business mailing address

5719 E GOSSAMER ST
LONG BEACH CA
90808-2713
US

V. Phone/Fax

Practice location:
  • Phone: 917-498-8192
  • Fax:
Mailing address:
  • Phone: 917-498-8192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAVISHANKARA SHASTRY
Title or Position: PRESIDENT
Credential:
Phone: 917-498-8261