Jason Matthew Smith, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT9432 Issued in CA

Practice address

47647 Caleo Bay Dr Ste 130
La Quinta, CA 92253-8857

Phone

(760) 771-9054

Fax

(760) 771-9057

NPI assigned

Oct 31, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1447536883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40239 CATANIA CT",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922033814",
            "telephone_number": "714-470-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47647 CALEO BAY DR STE 130",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922538857",
            "telephone_number": "760-771-9054",
            "fax_number": "760-771-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT9432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie K Shore, M.A., LMFT
• Anna Silva
• Sophai Simok
• Trishta Siqueiros-Villalta
• Robert Siskin
• Karen Renee Snake
• Social Services of Southern California a Licensed Clinical Social Work (Your Space Counseling)
• Delos Soehren Jr., D.C.
• Rita Soto, DDA
• Nash Sourial, D.D.S.

• Physical Therapy Assistant in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.