Active NPI
Emma Lyn Mendoza Santos, PT
- Physical Therapist
- El Cajon, CA
National Provider Identifier
1437695400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 296109
- Practice address
- 246 Hart Dr Apt 1311
El Cajon, CA 92021-4576 - Phone
- (954) 939-1963
- NPI assigned
- Jan 13, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62127 | OR | |
| Physical Therapist | 225100000X | 26325 | MD | |
| Physical Therapist | 225100000X | PT32271 | FL | |
| Physical Therapist | 225100000X | 296109 | CA | Primary |
Addresses
Primary practice location
246 Hart Dr Apt 1311
El Cajon, CA 92021-4576
Mailing address
246 Hart Dr Apt 1311
El Cajon, CA 92021-4576
Phone (954) 939-1963
Other practice location 1
7520 Surratts Rd
Clinton, MD 20735
Phone (954) 939-1963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W232050101 | Other | FL | AETNA |
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 |
|---|---|---|---|
| 296109 | CA | MD | Physical Therapist |
| PT32271 | FL | MD | Physical Therapist |
| 26325 | MD | MD | Physical Therapist |
| 62127 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1437695400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "246 HART DR APT 1311",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920214576",
"telephone_number": "954-939-1963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "246 HART DR APT 1311",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920214576",
"telephone_number": "954-939-1963"
}
],
"practiceLocations": [
{
"address_1": "7520 Surratts Rd",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "MD",
"postal_code": "20735",
"country_code": "US",
"telephone_number": "954-939-1963",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTOS",
"first_name": "EMMA LYN",
"middle_name": "MENDOZA",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-13",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "62127",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26325",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT32271",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "296109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "W232050101",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.