Healthcare Provider Details

I. General information

NPI: 1265229132
Provider Name (Legal Business Name): TRIDENT PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W ESPLANADE DR STE 1008
OXNARD CA
93036-1298
US

IV. Provider business mailing address

411 W ESPLANADE DR STE 1008
OXNARD CA
93036-1298
US

V. Phone/Fax

Practice location:
  • Phone: 805-941-0759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS LARKIN
Title or Position: PRESIDENT
Credential:
Phone: 805-941-0759