Active NPI
Willow Glen Optm Physical Therapy
- Physical Therapist
- San Jose, CA
National Provider Identifier
1285826016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT9672
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 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 DirectoryNPI 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.