Individual provider Active NPI

Jee-Hae J Son, P.T.

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1194908905
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 26191 Issued in CA
Practice address
4435 Eastgate Mall
#120
San Diego, CA 92121-1982
Phone
(858) 587-8669
Fax
(858) 587-8675
NPI assigned
Dec 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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 PT 26191 CA Primary

Addresses

Primary practice location

4435 Eastgate Mall
#120
San Diego, CA 92121-1982

Mailing address

317 N El Camino Real
#210
Encinitas, CA 92024-2811
Phone (760) 634-0248

Other names 1

  • Jennifer Richards Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 26191CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

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": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1194908905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL",
            "address_2": "#210",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242811",
            "telephone_number": "760-634-0248",
            "fax_number": "760-634-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 EASTGATE MALL",
            "address_2": "#120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211982",
            "telephone_number": "858-587-8669",
            "fax_number": "858-587-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "JEE-HAE",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 26191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RICHARDS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.