MEDICARE: JAYLA-KALINA HINES PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1497608277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYLA-KALINA HINES PT, DPT

Provider Business Mailing Address
First Line	:	11980 SAN VICENTE BLVD STE 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11980 SAN VICENTE BLVD STE 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-6602
Country	:	US
Telephone Number	:	310-479-2323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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