Healthcare Provider Details

I. General information

NPI: 1114710118
Provider Name (Legal Business Name): ANNIKA VOLBERT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11825 MAJOR ST STE 107
LOS ANGELES CA
90230-6356
US

IV. Provider business mailing address

15227 EASTWOOD AVE
LAWNDALE CA
90260-1775
US

V. Phone/Fax

Practice location:
  • Phone: 310-915-6100
  • Fax:
Mailing address:
  • Phone: 310-776-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308659
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: