Individual provider Active NPI

Jacquelyn Orellana

  • Physical Therapist
  • Upland, CA
National Provider Identifier
1316779713
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306384 Issued in CA
Practice address
846 W Foothill Blvd Ste C
Upland, CA 91786-3784
Phone
(909) 985-8686
Fax
(909) 985-5706
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 306384 CA Primary

Addresses

Primary practice location

846 W Foothill Blvd Ste C
Upland, CA 91786-3784

Mailing address

846 W Foothill Blvd Ste C
Upland, CA 91786-3784
Phone (909) 985-8686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926001154 CA Practitioner - Physical Therapist in Private Practice 8123569472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rozina and Smith Physical Therapy IncGroup PAC ID 9830268432, 9 clinicians

Practice addresses (Care Compare)

846 W Foothill Blvd
Suite C
Upland, CA 91786-3784
Phone (909) 985-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306384CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rozina and Smith Physical Therapy Inc. Physical Therapist CurrentSince Aug 15, 2024 Accepting new patients

Locations

846 W Foothill Blvd
Ste C
Upland, CA 91786
Phone (909) 985-8686

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1316779713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 W FOOTHILL BLVD STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863784",
            "telephone_number": "909-985-8686",
            "fax_number": "909-985-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 W FOOTHILL BLVD STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863784",
            "telephone_number": "909-985-8686",
            "fax_number": "909-985-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORELLANA",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.

Verify at the official NPI Registry.