Individual provider Active NPI

Jennifer Guan, PT, DPT

  • Physical Therapist
  • Los Altos, CA
National Provider Identifier
1194371351
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298295 Issued in CA
Practice address
4666 El Camino Real
Los Altos, CA 94022-1329
Phone
(650) 949-2339
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 044475-01 NY
Physical Therapist 225100000X 298295 CA Primary

Addresses

Primary practice location

4666 El Camino Real
Los Altos, CA 94022-1329

Mailing address

PO Box 1003
Los Altos, CA 94023-1003

Other practice location 1

340 Dardanelli Ln Ste 23
Los Gatos, CA 95032-1418
Phone (408) 884-8356

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
298295CAMDPhysical Therapist
044475-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist CurrentSince May 24, 2024 Accepting new patients
Golden State Physical Therapy Current Accepting new patients
Balance Dynamics Physical Therapy Inc Current Accepting new patients

Locations

4666 El Camino Real
Los Altos, CA 94022
Phone (650) 469-3638

340 Dardanelli Ln
Ste 23
Los Gatos, CA 95032
Phone (408) 626-9880

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1194371351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1003",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940231003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4666 EL CAMINO REAL",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221329",
            "telephone_number": "650-949-2339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Dardanelli Ln Ste 23",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950321418",
            "country_code": "US",
            "telephone_number": "408-884-8356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUAN",
        "first_name": "JENNIFER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044475-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.