Active NPI
Jason Carullo Sablan, RPT
- Physical Therapist
- Bakersfield, CA
National Provider Identifier
1356496673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2005013904
- Practice address
- 4101 Brittany St Apt 202
Bakersfield, CA 93312-2368 - Phone
- (417) 499-5185
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2005013904 | MO | Primary |
| Physical Therapist | 225100000X | PT33905 | CA |
Addresses
Primary practice location
4101 Brittany St Apt 202
Bakersfield, CA 93312-2368
Mailing address
4101 Brittany St Apt 202
Bakersfield, CA 93312-2368
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33905 | CA | MD | Social Worker |
| PT33905 | CA | MD | Physical Therapist |
| 2005013904 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1356496673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 BRITTANY ST APT 202",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933122368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 BRITTANY ST APT 202",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933122368",
"telephone_number": "417-499-5185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SABLAN",
"first_name": "JASON",
"middle_name": "CARULLO",
"name_prefix": "Mr.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2005013904",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT33905",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.