Individual provider Active NPI

Joann Jorgenson, PT

  • Physical Therapist
  • Lake Forest, CA
National Provider Identifier
1154331643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12630 Issued in CA
Practice address
22741 Lambert St
Lake Forest, CA 92630-1617
Phone
(949) 581-3839
Fax
(949) 454-6763
NPI assigned
Aug 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT12630 CA Primary

Addresses

Primary practice location

22741 Lambert St
Lake Forest, CA 92630-1617

Mailing address

24302 Tahoe CT
Laguna Niguel, CA 92677-7024
Phone (949) 362-8837

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
PT12630CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154331643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24302 TAHOE CT",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777024",
            "telephone_number": "949-362-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22741 LAMBERT ST",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301617",
            "telephone_number": "949-581-3839",
            "fax_number": "949-454-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSON",
        "first_name": "JOANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.