Healthcare Provider Details

I. General information

NPI: 1487323358
Provider Name (Legal Business Name): ASCENT ORTHOPEDIC PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S REINO RD STE 101
THOUSAND OAKS CA
91320-4285
US

IV. Provider business mailing address

400 S REINO RD STE 101
THOUSAND OAKS CA
91320-4285
US

V. Phone/Fax

Practice location:
  • Phone: 805-225-4754
  • Fax:
Mailing address:
  • Phone: 805-225-4754
  • 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: DANIELLE MARIE COOPER
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 920-740-9670