Nicole Renee Jensen

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

30675 Issued in AZ

Practice address

1530 Meridian Ave
Suite 150
San Jose, CA 95125-5350

Phone

(408) 979-2300

NPI assigned

May 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1225240773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2389 AZEVEDO PKWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951256654",
            "telephone_number": "408-999-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 MERIDIAN AVE",
            "address_2": "SUITE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255350",
            "telephone_number": "408-979-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-05",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25543",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "30675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Jensen
• Amanda Jensen, PA-C
• Angela Christine Jensen, MSW
• Benjamin C Jensen
• Jan Jensen
• Sarina Michelle Jensen, PA
• Skye Jensen
• William Albert Jensen, MD
• Albert Jeon, MD
• Sehyun Jeong, RPH

• Pediatric Physical Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.