Active NPI
Jesse Fejaran
- Massage Therapist
- Costa Mesa, CA
National Provider Identifier
1457931925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 48522
- Practice address
- 2000 Parsons St
Costa Mesa, CA 92627-2073 - Phone
- (808) 383-6759
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 48522 | CA | Primary |
Addresses
Primary practice location
2000 Parsons St
Costa Mesa, CA 92627-2073
Mailing address
3857 Birch St
Newport Beach, CA 92660-2616
Other practice location 1
20201 SW Birch St Ste 100
Newport Beach, CA 92660-1781
Phone (949) 259-5054
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 |
|---|---|---|---|
| 48522 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1457931925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 BIRCH ST",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 PARSONS ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272073",
"telephone_number": "808-383-6759"
}
],
"practiceLocations": [
{
"address_1": "20201 SW Birch St Ste 100",
"address_purpose": "LOCATION",
"city": "Newport Beach",
"state": "CA",
"postal_code": "926601781",
"country_code": "US",
"telephone_number": "949-259-5054",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FEJARAN",
"first_name": "JESSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-09",
"certification_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "48522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.