Active NPI
Jeena Elizabeth Jose
- Physical Therapist
- Redlands, CA
National Provider Identifier
1366809204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 38164
- Practice address
- 2025 Bluebird LN
Redlands, CA 92374-1655 - Phone
- (909) 553-9011
- NPI assigned
- Jan 22, 2016
- Sex
- Female
- Sole proprietor
- No
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 | PT 38164 | CA | Primary |
Addresses
Primary practice location
2025 Bluebird LN
Redlands, CA 92374-1655
Mailing address
2025 Bluebird LN
Redlands, CA 92374-1655
Phone (909) 553-9011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E3666017 | Other | CA | DRIVERS LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 38164 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453420800000",
"number": "1366809204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 BLUEBIRD LN",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923741655",
"telephone_number": "909-553-9011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 BLUEBIRD LN",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923741655",
"telephone_number": "909-553-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSE",
"first_name": "JEENA",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-22",
"last_updated": "2016-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 38164",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "E3666017",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
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- Ashlee Megan Jung, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.