Active NPI
Charlene Joy Umayam Lava, PT, DPT
- Physical Therapist
- San Mateo, CA
National Provider Identifier
1235784232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 296261
- Practice address
- 77 N San Mateo Dr Ste 2
San Mateo, CA 94401-2853 - Phone
- (650) 343-5678
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 296261 | CA | Primary |
Addresses
Primary practice location
77 N San Mateo Dr Ste 2
San Mateo, CA 94401-2853
Mailing address
124 Park Blvd Apt 1
Millbrae, CA 94030-1254
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1235784232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 PARK BLVD APT 1",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 N SAN MATEO DR STE 2",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944012853",
"telephone_number": "650-343-5678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVA",
"first_name": "CHARLENE JOY",
"middle_name": "UMAYAM",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "296261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.