Active NPI
Jessica Reardon
- Physical Therapist
- Marina del Rey, CA
National Provider Identifier
1346615176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 43381
- Practice address
- 4702 Lincoln Blvd
Marina del Rey, CA 90292-6902 - Phone
- (310) 306-1478
- NPI assigned
- Dec 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 43381 | CA | Primary |
Addresses
Primary practice location
4702 Lincoln Blvd
Marina del Rey, CA 90292-6902
Mailing address
4702 Lincoln Blvd
Marina del Rey, CA 90292-6902
Phone (310) 306-1478
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1346615176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4702 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926902",
"telephone_number": "310-306-1478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4702 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926902",
"telephone_number": "310-306-1478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-04",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "43381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
- Jonathan David Rand, MD
- Reshma Rangwani Lakhani, L.C.S.W.
- Raymon T. Kaplan M.D., Inc.
- Nathan Michel Razbannia, MD
- Julia Isabelle Reading, MD
- Reed Chiropractic & Wellness Center a Professional Corporation
- Reed Chiropractic & Wellness Center a Professional Corporation
- David Michael Reed, D.C.
- Melanie Kaye Reed, NP
- Regenerative Health and Wellness Institute
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.