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NPI Code Detail

MEDICARE: ERYKA KHAKASA WANYONYI DPT

MEDICARE: ERYKA KHAKASA WANYONYI 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1790642254
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERYKA KHAKASA WANYONYI DPT
Provider Business Mailing Address
First Line : 901 COLGATE
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-1817
Country : US
Telephone Number : 573-823-3013
Fax Number :
Provider Business Practice Location Address
First Line : 6041 CADILLAC AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-1702
Country : US
Telephone Number : 833-574-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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