Active NPI
Jeanine Michelsen
- Physical Therapist
- Concord, CA
National Provider Identifier
1144926163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39250
- Practice address
- 3807 Concord Blvd
Concord, CA 94519-1809 - Phone
- (312) 497-3417
- NPI assigned
- Feb 1, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 39250 | CA | Primary |
Addresses
Primary practice location
3807 Concord Blvd
Concord, CA 94519-1809
Mailing address
3807 Concord Blvd
Concord, CA 94519-1809
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 |
|---|---|---|---|
| 39250 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1144926163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3807 CONCORD BLVD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945191809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 CONCORD BLVD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945191809",
"telephone_number": "312-497-3417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELSEN",
"first_name": "JEANINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-01",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.