Active NPI
Jared Lee Acevedo, DPT
- Student in an Organized Health Care Education/Training Program
- Bellflower, CA
National Provider Identifier
1093043846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 36216
- Practice address
- 17873 Balfern Ave
Bellflower, CA 90706-7154 - Phone
- (562) 301-8744
- NPI assigned
- Dec 4, 2009
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 36216 | CA | Primary |
Addresses
Primary practice location
17873 Balfern Ave
Bellflower, CA 90706-7154
Mailing address
17873 Balfern Ave
Bellflower, CA 90706-7154
Phone (562) 301-8744
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36216 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259884800000",
"number": "1093043846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17873 BALFERN AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907067154",
"telephone_number": "562-301-8744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17873 BALFERN AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907067154",
"telephone_number": "562-301-8744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACEVEDO",
"first_name": "JARED",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-04",
"last_updated": "2009-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "36216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellflower, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.