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

Michelle M Theis-Black, PTA

Individual provider Physical Therapy Assistant · NPI 1679064927

Michelle M Theis-Black, PTA is a Physical Therapy Assistant in Santa Monica, California. Licensed in California. Registered with an NPI since 2018.

Licensed in
CA
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

2730 Wilshire Blvd Ste 533
Santa Monica, CA 90403-4751
Phone: (310) 828-0101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 49327 (CA)

Record details

NPI number1679064927
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 22, 2018
Last updated in NPPESMay 22, 2018

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