Jo Anne Carpenter, PT

Individual provider Active NPI Pediatric Physical Therapist · Cypress, CA

NPI 1376778282 · NPPES record last updated May 20, 2009

Key facts

NPI
1376778282
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
PT24154 (CA)
Practice address
11105 Knott Ave
Suite a
Cypress, CA 90630-5137
Phone
(714) 893-7399
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT24154CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Pediatric Physical Therapy, Inc Pediatrics Past Accepting new patients
Childrens Learning Connection, LLC Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT24154 CA Yes

Addresses

Primary practice location

11105 Knott Ave
Suite a
Cypress, CA 90630-5137

Mailing address

11105 Knott Ave
Suite a
Cypress, CA 90630-5137

Other providers in Cypress, CA

All providers in Cypress, CA · Pediatric Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.