Active NPI
Eriko Shimojo
- Physical Therapy Assistant
- Garden Grove, CA
National Provider Identifier
1164970422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 48151
- Practice address
- 12562 Garden Grove Blvd
Garden Grove, CA 92843-1907 - Phone
- (714) 705-4027
- NPI assigned
- Sep 15, 2016
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 48151 | CA | Primary |
Addresses
Primary practice location
12562 Garden Grove Blvd
Garden Grove, CA 92843-1907
Mailing address
101 W Mission Blvd
St. #110 Box #397
Pomona, CA 91766-1711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48151 | Other | CA | PTA |
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 |
|---|---|---|---|
| 48151 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1164970422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W MISSION BLVD",
"address_2": "ST. #110 BOX #397",
"city": "POMONA",
"state": "CA",
"postal_code": "917661711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12562 GARDEN GROVE BLVD",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928431907",
"telephone_number": "714-705-4027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMOJO",
"first_name": "ERIKO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-15",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "48151",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTA",
"identifier": "48151",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.