Latiesha Jasmin Camacho, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306604855 Issued in VA

Practice address

14906 Jefferson Davis Hwy
Woodbridge, VA 22191-4016

Phone

(703) 491-6167

NPI assigned

Oct 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1225548258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10429 SUMMER HILL RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231166613",
            "telephone_number": "804-938-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14906 JEFFERSON DAVIS HWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914016",
            "telephone_number": "703-491-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "LATIESHA",
        "middle_name": "JASMIN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Aubin Cadet-Bouzi, FNP
• Karina T. Calderon
• Keira Lee Ann Cale
• Erin Kelly Callahan, M.S., CF-SLP
• Allison Callow, APRN, CPNP-PC
• Camellia Home Care Agency LLC
• Brianna Campbell
• Jamie D Campbell
• Peter Lawrence Campbell, M.D.
• Carmen Ana Cancel-de Jesus, PT

• Physical Therapy Assistant in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.