Organization Active NPI

Willow Glen Optm Physical Therapy

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1285826016
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9672 Issued in CA
Legal business name
WILLOW GLEN OPTM PHYSICAL THERAPY
Practice address
1530 Meridian Ave
Suite 150
San Jose, CA 95125-5350
Phone
(408) 354-2223
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul L Christensen, PT
Title
President
Phone
(408) 354-2223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT9672 CA Primary

Addresses

Primary practice location

1530 Meridian Ave
Suite 150
San Jose, CA 95125-5350

Mailing address

1530 Meridian Ave
Suite 150
San Jose, CA 95125-5350
Phone (408) 354-2223

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1285826016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 MERIDIAN AVE",
            "address_2": "SUITE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255350",
            "telephone_number": "408-354-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 MERIDIAN AVE",
            "address_2": "SUITE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255350",
            "telephone_number": "408-354-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW GLEN OPTM PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-354-2223",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.