Individual provider Active NPI

Jizelle Jaelynn Kaulu, NMT

  • Massage Therapist
  • Pasadena, CA
National Provider Identifier
1003517830
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
92755 Issued in CA
Practice address
64 Harkness Ave Apt 6
Pasadena, CA 91106-2038
Phone
(310) 780-4386
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 92755 CA Primary

Addresses

Primary practice location

64 Harkness Ave Apt 6
Pasadena, CA 91106-2038

Mailing address

64 Harkness Ave Apt 6
Pasadena, CA 91106-2038
Phone (310) 780-4386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1003517830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 HARKNESS AVE APT 6",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062038",
            "telephone_number": "310-780-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 HARKNESS AVE APT 6",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062038",
            "telephone_number": "310-780-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAULU",
        "first_name": "JIZELLE",
        "middle_name": "JAELYNN",
        "credential": "NMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "92755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.