Active NPI
Jairo Lenin Duarte
- Massage Therapist
- Santa Clarita, CA
National Provider Identifier
1104410695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 79431
- Practice address
- 23007 Garzota Dr
Santa Clarita, CA 91354-2230 - Phone
- (661) 877-0549
- NPI assigned
- Feb 24, 2021
- Last updated
- Feb 24, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 79431 | CA | Primary |
Addresses
Primary practice location
23007 Garzota Dr
Santa Clarita, CA 91354-2230
Mailing address
23007 Garzota Dr
Santa Clarita, CA 91354-2230
Phone (661) 877-0549
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y4317983 | Other | CA | EMERGENCY |
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 |
|---|---|---|---|
| 79431 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1104410695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23007 GARZOTA DR",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913542230",
"telephone_number": "661-877-0549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23007 GARZOTA DR",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913542230",
"telephone_number": "661-877-0549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "JAIRO",
"middle_name": "LENIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-24",
"last_updated": "2021-02-24",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "79431",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMERGENCY",
"identifier": "Y4317983",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Clarita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.