Individual provider Active NPI

Jacalyn D. Harris, R.P.T.

  • Neurology Physical Therapist
  • Berkeley, CA
National Provider Identifier
1205193125
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
PT8449 Issued in CA
Practice address
2737 Forest Ave
Apt. 202
Berkeley, CA 94705-1360
Phone
(510) 848-3974
NPI assigned
Apr 17, 2012
Last updated
Apr 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X PT8449 CA Primary

Addresses

Primary practice location

2737 Forest Ave
Apt. 202
Berkeley, CA 94705-1360

Mailing address

2737 Forest Ave
Apt. 202
Berkeley, CA 94705-1360
Phone (510) 848-3974

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
PT8449CAMDNeurology Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1205193125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 FOREST AVE",
            "address_2": "APT. 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051360",
            "telephone_number": "510-848-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 FOREST AVE",
            "address_2": "APT. 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051360",
            "telephone_number": "510-848-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACALYN",
        "middle_name": "D.",
        "credential": "R.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "PT8449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.