Jennifer Elizabeth Fuller, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

296647 Issued in CA

Practice address

6080 Center Dr.
6TH Floor Suite # 639
Los Angeles, CA 90045-9205

Phone

(888) 859-0145

NPI assigned

Jun 2, 2009

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

Other names 1

• Jennifer Elizabeth Stoeck Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD
• In-Home Physical Therapy PC

  • Multi-Specialty Clinic/Center
  • Encinitas, CA
  • NPI 1588800874
  Medicare reassignment NPD
• Mesisca Physical Therapy Inc

  • Geriatric Physical Therapist
  • Laguna Niguel, CA
  • NPI 1821104472
  Medicare reassignment NPD
• Praxis Physical Therapy, Inc.

  • Physical Therapist
  • San Pedro, CA
  • NPI 1003960949
  Medicare reassignment NPD
• Highline Physical Therapy Group

  • Physical Therapist
  • Bonney Lake, WA
  • NPI 1255147336
  NPD
• Highline Physical Therapy Group

  • Physical Therapist
  • Burien, WA
  • NPI 1477797991
  NPD
• JM Physical Therapy Inc

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1558658336
  NPD (past)

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1265668446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MAIN ST FL 2",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913626",
            "telephone_number": "888-859-0145",
            "fax_number": "888-858-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 CENTER DR.",
            "address_2": "6TH FLOOR SUITE # 639",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459205",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012756",
            "country_code": "US",
            "telephone_number": "888-862-2737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Main St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "CA",
            "postal_code": "902913626",
            "country_code": "US",
            "telephone_number": "888-859-0145",
            "fax_number": "888-858-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60044173",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "STOECK",
            "middle_name": "ELIZABETH",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claire V. Fuller, MD
• Clark Beeman Fuller, M.D.
• David Lee Fuller II, M.D.
• Deborah Fuller, MA
• Jack G. Fuller, PA-C
• Laura Marie Fuller, MFT INTERN
• M. Camille Fuller, D.D.S.
• Myesha Fuller, CMT
• Perry Fuller
• Samantha Elizeth Fuller

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.