Individual provider Active NPI

Jaffa Dadoun, PT

  • Physical Therapist
  • Redwood City, CA
National Provider Identifier
1376790048
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15349 Issued in CA
Practice address
1100 Veterans BLV
Redwood City, CA 94063
Phone
(650) 299-4338
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 15349 CA Primary

Addresses

Primary practice location

1100 Veterans BLV
Redwood City, CA 94063

Mailing address

600 Sharon Park Dr Apt B204
Menlo Park, CA 94025-6995

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

LicenseStateTypeSpecialty
15349CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1376790048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SHARON PARK DR APT B204",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940256995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VETERANS BLV",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94063",
            "telephone_number": "650-299-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADOUN",
        "first_name": "JAFFA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "15349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.