Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Theraform Physical Therapy, Inc

Organization Physical Therapist · NPI 1902754542

Theraform Physical Therapy, Inc is a Physical Therapist in Los Angeles, California. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12658 W Washington Blvd Unit 103
Los Angeles, CA 90066-2300
Phone: (310) 292-0780
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1902754542
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jocelyn Randall — President & Owner · (310) 292-0780
NPI enumeratedMarch 19, 2026
Last updated in NPPESMarch 24, 2026
Certification dateMarch 24, 2026
Mailing address3181 Barbados Pl, Costa Mesa, CA 92626-2301

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