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

Shane Vidal

Individual provider Physical Therapy Assistant · NPI 1831903905

Shane Vidal is a Physical Therapy Assistant in Northridge, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

11260 Wilbur Ave Ste 101
Northridge, CA 91326-2450
Phone: (818) 832-5656
Fax: (818) 838-5245
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 53866 (CA)

Record details

NPI number1831903905
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 6, 2025
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025
Mailing address22003 Liggett St, Chatsworth, CA 91311-5721

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