Individual provider Active NPI

Jennifer Marie Keitzman

  • Massage Therapist
  • Whittier, CA
National Provider Identifier
1114612413
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
79936 Issued in CA
Practice address
7624 Painter Ave Ste 200
Whittier, CA 90602-2328
Phone
(562) 789-8661
NPI assigned
Apr 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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 79936 CA Primary

Addresses

Primary practice location

7624 Painter Ave Ste 200
Whittier, CA 90602-2328

Mailing address

153 Spinks Canyon Rd
Bradbury, CA 91008-1244
Phone (626) 739-8627

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

LicenseStateTypeSpecialty
79936CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1114612413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 SPINKS CANYON RD",
            "city": "BRADBURY",
            "state": "CA",
            "postal_code": "910081244",
            "telephone_number": "626-739-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7624 PAINTER AVE STE 200",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906022328",
            "telephone_number": "562-789-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITZMAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "79936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.