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

Buenaventura Gaviola Agraviador III, PTLA

Individual provider Physical Therapist · NPI 1366116170

Buenaventura Gaviola Agraviador III, PTLA is a Physical Therapist in Private Practice in Northridge, California. Qualified in 2024, 2 years ago. Practices with Sansum Clinic, a 320-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2021
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

18709 Frankfort St
Northridge, CA 91324-4523
Phone: (818) 358-9992
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PTLA (CA)

Record details

NPI number1366116170
Entity typeIndividual (Type 1)
GenderMale
Credentials PTLA
Sole proprietorYes
NPI enumeratedAugust 4, 2021
Last updated in NPPESAugust 4, 2023
Certification dateAugust 4, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sansum Clinic — 320 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Northridge