Healthcare Provider Details

I. General information

NPI: 1255247839
Provider Name (Legal Business Name): MICHAEL JAMES ARSENEAU PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 CANOGA AVE STE 120
WOODLAND HILLS CA
91367-6514
US

IV. Provider business mailing address

8210 QUARTZ AVE
WINNETKA CA
91306-1945
US

V. Phone/Fax

Practice location:
  • Phone: 747-255-4089
  • Fax:
Mailing address:
  • Phone: 818-336-7609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54911
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: