Individual provider Active NPI

Mariel Jacques Lansang, PT, DPT

  • Pediatric Physical Therapist
  • Santa Ana, CA
National Provider Identifier
1336500719
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
2700 N Main St Ste 945
Santa Ana, CA 92705-6678
Phone
(714) 542-1234
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X Primary

Addresses

Primary practice location

2700 N Main St Ste 945
Santa Ana, CA 92705-6678

Mailing address

11721 186TH St
Artesia, CA 90701-5520
Phone (714) 486-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43338CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Progress Speech & Language Pathology Center, Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1336500719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 186TH ST",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907015520",
            "telephone_number": "714-486-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N MAIN ST STE 945",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056678",
            "telephone_number": "714-542-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSANG",
        "first_name": "MARIEL",
        "middle_name": "JACQUES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.