Active NPI
Sharon Jackola, P.T.
- Physical Therapist
- North Hills, CA
National Provider Identifier
1265740682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT17648
- Practice address
- 9231 Natick Ave
North Hills, CA 91343-3421 - Phone
- (818) 893-4204
- NPI assigned
- Sep 20, 2010
- 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 | PT17648 | CA | Primary |
Addresses
Primary practice location
9231 Natick Ave
North Hills, CA 91343-3421
Mailing address
9231 Natick Ave
North Hills, CA 91343-3421
Phone (818) 893-4204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Westlake Village, CA 91362
Phone (877) 407-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT17648 | CA | MD | Physical Therapist |
| 17648 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Physical Therapy Ca PC | Physical Therapist | Current | Accepting new patients |
Locations
16868 Via del Campo Ct
#1001182
San Diego, CA 92127
16868 Via del Campo Ct
Ste 100
San Diego, CA 92127
Phone (858) 239-8469
95 Duesenberg Dr
Westlake Village, CA 91362
Phone (805) 413-3300
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.
-
- Physical Therapist
- San Diego, CA
- NPI 1972330298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1265740682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9231 NATICK AVE",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913433421",
"telephone_number": "818-893-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9231 NATICK AVE",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913433421",
"telephone_number": "818-893-4204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKOLA",
"first_name": "SHARON",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT17648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.