Active NPI
Danielle Jack
- Physical Therapist
- Murrieta, CA
National Provider Identifier
1407217656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 291107
- Practice address
- 41421 Date St Ste 101
Murrieta, CA 92562-7079 - Phone
- (855) 454-3784
- Fax
- (855) 454-3784
- NPI assigned
- Mar 16, 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 | 291107 | CA | Primary |
Addresses
Primary practice location
41421 Date St Ste 101
Murrieta, CA 92562-7079
Mailing address
9898 Erma Rd
San Diego, CA 92131-2419
Phone (408) 691-3387
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 |
|---|---|---|---|
| 291107 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Littlefield Physical Therapy, Inc. | Past | Accepting new patients | |
| Littlefield Physical Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Murrieta, CA
- NPI 1467506691
-
- Point of Service
- Murrieta, CA
- NPI 1548694961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1407217656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9898 ERMA RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921312419",
"telephone_number": "408-691-3387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41421 DATE ST STE 101",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925627079",
"telephone_number": "855-454-3784",
"fax_number": "855-454-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACK",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "291107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.