Individual provider Active NPI

Jane Quach, PT

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1245350651
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015640 Issued in IL
Practice address
2211 Bush St 100
San Francisco, CA 94115-3121
Phone
(415) 440-4151
Fax
(415) 440-4142
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 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 070015640 IL Primary

Addresses

Primary practice location

2211 Bush St 100
San Francisco, CA 94115-3121

Mailing address

2211 Bush St 100
San Francisco, CA 94115-3121
Phone (415) 440-4151

Other identifiers 2

IdentifierTypeStateIssuer
P00931630OtherILMEDICARE RAILROAD
P00684873OtherILRAILROAD MEDICARE

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
39076CAMDGeneral Practice Dentistry
070015640ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Sports Rehabilitation, Inc. CurrentSince Aug 1, 2012 Accepting new patients

Locations

1809 E Dyer Rd
Ste 311
Santa Ana, CA 92705
Phone (949) 863-0022

11627 Telegraph Rd
Ste 105
Santa Fe Springs, CA 90670
Phone (562) 948-4004

Organizations & group practices 1

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1245350651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 BUSH ST 100",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153121",
            "telephone_number": "415-440-4151",
            "fax_number": "415-440-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 BUSH ST 100",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153121",
            "telephone_number": "415-440-4151",
            "fax_number": "415-440-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACH",
        "first_name": "JANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00931630",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00684873",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

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