Individual provider Active NPI

Jorge Alberto Vasquez

  • Massage Therapist
  • Canoga Park, CA
National Provider Identifier
1083369409
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
63402 Issued in CA
Practice address
6823 Variel Ave Apt 1
Canoga Park, CA 91303-2257
Phone
(323) 359-8468
NPI assigned
Feb 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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 63402 CA Primary

Addresses

Primary practice location

6823 Variel Ave Apt 1
Canoga Park, CA 91303-2257

Mailing address

6823 Variel Ave Apt 1
Canoga Park, CA 91303-2257
Phone (323) 359-8468

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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1083369409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 VARIEL AVE APT 1",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032257",
            "telephone_number": "323-359-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 VARIEL AVE APT 1",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032257",
            "telephone_number": "323-359-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JORGE",
        "middle_name": "ALBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "63402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.