Healthcare Provider Details

I. General information

NPI: 1851082812
Provider Name (Legal Business Name): SECOND WAVE PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2367 N OXNARD BLVD
OXNARD CA
93036-2000
US

IV. Provider business mailing address

2367 N OXNARD BLVD
OXNARD CA
93036-2000
US

V. Phone/Fax

Practice location:
  • Phone: 805-250-7505
  • Fax: 805-250-7171
Mailing address:
  • Phone: 805-250-7505
  • Fax: 805-250-7171

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: STEPHANIE CATTANO
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 860-459-6735