Individual provider Active NPI

Jessica Diab, PT,DPT

  • Physical Therapist
  • San Dimas, CA
National Provider Identifier
1023610854
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299382 Issued in CA
Practice address
309 Pony Express Rd
San Dimas, CA 91773-2780
Phone
(909) 519-1672
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299382 CA Primary

Addresses

Primary practice location

309 Pony Express Rd
San Dimas, CA 91773-2780

Mailing address

309 Pony Express Rd
San Dimas, CA 91773-2780
Phone (909) 519-1672

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
299382CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Physical Therapy, P.C. Physical Therapist CurrentSince Jan 26, 2023 Accepting new patients
The Hand & Upper Extremity Center Inc Physical Therapist PastSince Jan 26, 2023 Accepting new patients

Locations

599 S Barranca Ave
Covina, CA 91723
Phone 81889422738020

5806 Pacific Blvd
Huntington Park, CA 90255

5450 W Pico Blvd
Ste 202
Los Angeles, CA 90019
Phone (214) 893-2790

8929 Aero Dr
Ste E
San Diego, CA 92123
Phone (858) 277-2277

6320 Canoga Ave
Fl 15
Woodland Hls, CA 91367
Phone (818) 588-4003

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1023610854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 PONY EXPRESS RD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732780",
            "telephone_number": "909-519-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 PONY EXPRESS RD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732780",
            "telephone_number": "909-519-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAB",
        "first_name": "JESSICA",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.