Individual provider Active NPI

Jani Cris Junio Angeles, PTA

  • Physical Therapy Assistant
  • Simi Valley, CA
National Provider Identifier
1346547478
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 6854 Issued in CA
Practice address
4844 Monument St
Simi Valley, CA 93063-0424
Phone
(805) 813-1743
Fax
(805) 577-1388
NPI assigned
Feb 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 6854 CA Primary

Addresses

Primary practice location

4844 Monument St
Simi Valley, CA 93063-0424

Mailing address

4844 Monument St
Simi Valley, CA 93063-0424
Phone (805) 813-1743

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT 6854CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1346547478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 MONUMENT ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630424",
            "telephone_number": "805-813-1743",
            "fax_number": "805-577-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 MONUMENT ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930630424",
            "telephone_number": "805-813-1743",
            "fax_number": "805-577-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "JANI CRIS",
        "middle_name": "JUNIO",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 6854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.