Active NPI
Jessica Gadayan
- Physical Therapist
- Albany, CA
National Provider Identifier
1407335573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 295192
- Practice address
- 948 San Pablo Ave
Albany, CA 94706-2010 - Phone
- (510) 526-2353
- Fax
- (510) 526-2022
- NPI assigned
- Aug 9, 2018
- Last updated
- Aug 18, 2020
- 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 | 295192 | Primary |
Addresses
Primary practice location
948 San Pablo Ave
Albany, CA 94706-2010
Mailing address
1950 Franklin St
Oakland, CA 94612-5190
Other practice location 1
3701 Broadway
Oakland, CA 94611-5613
Phone (510) 752-6179
Other names 1
- Jessica Clark
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1407335573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 FRANKLIN ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946125190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "948 SAN PABLO AVE",
"city": "ALBANY",
"state": "CA",
"postal_code": "947062010",
"telephone_number": "510-526-2353",
"fax_number": "510-526-2022"
}
],
"practiceLocations": [
{
"address_1": "3701 Broadway",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946115613",
"country_code": "US",
"telephone_number": "510-752-6179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GADAYAN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-09",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "295192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "CLARK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Albany, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.