Individual provider Active NPI

Jessica Sarah Von Den Stemmen, M.P.T.

  • Physical Therapist
  • Westlake Village, CA
National Provider Identifier
1164856001
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40402 Issued in CA
Practice address
1220 La Venta Dr
Suite # 102
Westlake Village, CA 91361-3703
Phone
(805) 777-7370
Fax
(805) 777-7380
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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 40402 CA Primary

Addresses

Primary practice location

1220 La Venta Dr
Suite # 102
Westlake Village, CA 91361-3703

Mailing address

2730 Wilshire Blvd
Ste 105
Santa Monica, CA 90403-4724
Phone (805) 777-7370

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131226001383 CA Practitioner - Physical Therapist in Private Practice 6406083278 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40402CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jun 24, 2019 Accepting new patients
Westlake Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1164856001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "STE 105",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034724",
            "telephone_number": "805-777-7370",
            "fax_number": "805-777-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE # 102",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-777-7370",
            "fax_number": "805-777-7380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON DEN STEMMEN",
        "first_name": "JESSICA",
        "middle_name": "SARAH",
        "name_prefix": "Ms.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.