NPIMap

Organization Active NPI

JBJC Inc.

Doing business as Pine Street Physical & Occupational Therapy

  • Physical Therapy Clinic/Center
  • Stockton, CA
National Provider Identifier
1417037946
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2403966 Issued in CA
Legal business name
JBJC INC.
Doing business as
Pine Street Physical & Occupational Therapy
Practice address
534 E Pine St
Suite a
Stockton, CA 95204-5536
Phone
(209) 463-5800
Fax
(209) 463-5900
NPI assigned
Oct 17, 2006
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Mr. Jack Jones
Title
Authorized Official
Phone
(678) 837-7176

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X 2403966 CA Primary

Addresses

Primary practice location

534 E Pine St
Suite a
Stockton, CA 95204-5536

Mailing address

PO Box 200880
Dallas, TX 75320-0880
Phone (678) 837-7176

Other practice location 1

7560 Elk Grove Blvd Ste 130
Elk Grove, CA 95757-6468
Phone (916) 844-2794

Other practice location 2

2488 N California St
Stockton, CA 95204-5508
Phone (209) 981-7390

Other practice location 3

1640 W Yosemite Ave Ste 1
Manteca, CA 95337-5192
Phone (209) 328-1738

Other practice location 4

2357 W March Ln
Stockton, CA 95207-5239
Phone (209) 477-9300

Other practice location 5

10200 Trinity Pkwy Ste 205
Stockton, CA 95219-7288
Phone (209) 451-3920

Other practice location 6

1073 E Shaw Ave
Fresno, CA 93710-7806
Phone (559) 227-4440

Other practice location 7

6385 Pacific Ave
Stockton, CA 95207
Phone (209) 477-9300

Other practice location 8

840 S Fairmont Ave Ste 5
Lodi, CA 95240-5105
Phone (209) 339-1690

Other names 1

  • Pine Street Physical & Occupational Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826000460 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830164649 Receives reassigned benefits from 19 practitioners
Practice locations: Elk Grove, CA; Fresno, CA; Stockton, CA

National Provider Directory

National Provider Directory

Locations

7560 Elk Grove Blvd
Ste 130
Elk Grove, CA 95757
Phone (916) 844-2794

10200 Trinity Pkwy
Ste A
Stockton, CA 95219

6385 Pacific Ave
Stockton, CA 95207
Phone (209) 477-9300

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1417037946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200880",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200880",
            "telephone_number": "678-837-7176",
            "fax_number": "404-777-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 E PINE ST",
            "address_2": "SUITE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045536",
            "telephone_number": "209-463-5800",
            "fax_number": "209-463-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7560 Elk Grove Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957576468",
            "country_code": "US",
            "telephone_number": "916-844-2794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2488 N California St",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952045508",
            "country_code": "US",
            "telephone_number": "209-981-7390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 W Yosemite Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953375192",
            "country_code": "US",
            "telephone_number": "209-328-1738",
            "fax_number": "209-328-1055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2357 W March Ln",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952075239",
            "country_code": "US",
            "telephone_number": "209-477-9300",
            "fax_number": "209-477-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10200 Trinity Pkwy Ste 205",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952197288",
            "country_code": "US",
            "telephone_number": "209-451-3920",
            "fax_number": "209-451-3902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1073 E Shaw Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937107806",
            "country_code": "US",
            "telephone_number": "559-227-4440",
            "fax_number": "559-227-4443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6385 Pacific Ave",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "95207",
            "country_code": "US",
            "telephone_number": "209-477-9300",
            "fax_number": "209-477-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 S Fairmont Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952405105",
            "country_code": "US",
            "telephone_number": "209-339-1690",
            "fax_number": "209-339-1693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JBJC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "678-837-7176",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "2403966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Street Physical & Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pine Street Physical & Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.