Individual provider Active NPI

Jann-Eric Victoriano, PT, DPT

  • Physical Therapist
  • Lakewood, CA
National Provider Identifier
1255119848
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304622 Issued in CA
Practice address
3518 Arbor Rd
Lakewood, CA 90712-3409
Phone
(562) 480-7991
NPI assigned
Sep 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 304622 CA Primary

Addresses

Primary practice location

3518 Arbor Rd
Lakewood, CA 90712-3409

Mailing address

3518 Arbor Rd
Lakewood, CA 90712-3409
Phone (562) 480-7991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101001228 CA Practitioner - Physical Therapist in Private Practice 6305292079 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304622CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehab & Sports Therapy CurrentSince Oct 2, 2023 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jul 18, 2024 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist CurrentSince Oct 2, 2023 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist Current Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

1640 Newport Blvd
Ste 260
Costa Mesa, CA 92627
Phone (949) 335-7967

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

200 Newport Center Dr
Ste 213
Newport Beach, CA 92660
Phone (949) 644-0316

19000 Hawthorne Blvd
Ste 300
Torrance, CA 90503
Phone (310) 793-1800

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 4

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1255119848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 ARBOR RD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907123409",
            "telephone_number": "562-480-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 ARBOR RD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907123409",
            "telephone_number": "562-480-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIANO",
        "first_name": "JANN-ERIC",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.