Active NPI
Jesse Caceres
- Physical Therapy Assistant
- Van Nuys, CA
National Provider Identifier
1063279610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 54750
- Practice address
- 7100 Van Nuys Blvd Ste 103
Van Nuys, CA 91405-3063 - Phone
- (310) 504-3135
- NPI assigned
- Feb 29, 2024
- Last updated
- May 5, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 54750 | CA | Primary |
Addresses
Primary practice location
7100 Van Nuys Blvd Ste 103
Van Nuys, CA 91405-3063
Mailing address
7100 Van Nuys Blvd Ste 103
Van Nuys, CA 91405-3063
Phone (310) 504-3135
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54750 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Profizix Physical Therapy and Wellness P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Hand Physical Therapist
- Los Angeles, CA
- NPI 1083213961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777939200000",
"number": "1063279610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7100 VAN NUYS BLVD STE 103",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914053063",
"telephone_number": "310-504-3135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7100 VAN NUYS BLVD STE 103",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914053063",
"telephone_number": "310-504-3135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CACERES",
"first_name": "JESSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-29",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "54750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.