Active NPI
Jane H Canseco
- Rehabilitation Practitioner
- Long Beach, CA
National Provider Identifier
1386878288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 59756
- Practice address
- 2931 Redondo Ave
Long Beach, CA 90806-2445 - Phone
- (562) 490-7600
- Fax
- (562) 490-7601
- NPI assigned
- May 6, 2009
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 59756 | CA | Primary |
Addresses
Primary practice location
2931 Redondo Ave
Long Beach, CA 90806-2445
Mailing address
7204 E Pony CT
Orange, CA 92869-4514
Phone (714) 538-0706
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 |
|---|---|---|---|
| 59756 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1386878288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7204 E PONY CT",
"city": "ORANGE",
"state": "CA",
"postal_code": "928694514",
"telephone_number": "714-538-0706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2931 REDONDO AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062445",
"telephone_number": "562-490-7600",
"fax_number": "562-490-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANSECO",
"first_name": "JANE",
"middle_name": "H",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-06",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "59756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.