Angelika Faith Pel Agahan, PT

Individual provider Active NPI Physical Therapist · Jackson, CA

NPI 1003550583 · NPPES record last updated Mar 19, 2026

Key facts

NPI
1003550583
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
301977 (CA)
Practice address
12150 Industry Blvd Ste 42
Jackson, CA 95642-9375
Phone
(530) 223-9410
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PC (769 clinicians)

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220610000479 CA Practitioner - Physical Therapist in Private Practice 8820476401 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist Current
since Oct 30, 2023
Accepting new patients
Fitzpatrick Physical Therapy Inc. Physical Therapist Current
since Apr 21, 2022
Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist Current
since Oct 30, 2023
Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

12150 Industry Blvd
Ste 42
Jackson, CA 95642
Phone (209) 223-9410

2240 E Plaza Blvd
Ste Be
National City, CA 91950
Phone (619) 474-5916

1252 Broadway
Ste B
Placerville, CA 95667
Phone (530) 622-9410

1252 Broadway
Placerville, CA 95667
Phone (318) 680-8208

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

5850 Canoga Ave
Ste 120
Woodland Hills, CA 91367
Phone (747) 255-4089

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 301977 CA Yes

Addresses

Primary practice location

12150 Industry Blvd Ste 42
Jackson, CA 95642-9375

Mailing address

1252 Broadway
Placerville, CA 95667-5822
Phone (530) 223-9410

Electronic endpoints

TypeEndpointUseAffiliation
Other URL Clinicient

Other providers in Jackson, CA

All providers in Jackson, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.