Individual provider Active NPI

Jeremiah Nyanda Chacha

  • Physical Therapist
  • Turlock, CA
National Provider Identifier
1194316232
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299688 Issued in CA
Practice address
1801 N Olive Ave
Turlock, CA 95382-2568
Phone
(209) 410-7200
NPI assigned
Feb 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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 299688 CA Primary

Addresses

Primary practice location

1801 N Olive Ave
Turlock, CA 95382-2568

Mailing address

5024 Santa Rita Rd
El Sobrante, CA 94803-3236
Phone (510) 691-2889

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
299688CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1194316232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 SANTA RITA RD",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948033236",
            "telephone_number": "510-691-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N OLIVE AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822568",
            "telephone_number": "209-410-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACHA",
        "first_name": "JEREMIAH",
        "middle_name": "NYANDA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.