Mariano Jervoso Mempin III, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

52735 Issued in CA

Practice address

1604 Blossom Hill Rd Ste 10
San Jose, CA 95124-6350

Phone

(408) 528-8833

NPI assigned

Mar 6, 2024

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": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1467219329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37171 SYCAMORE ST APT 625",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603975",
            "telephone_number": "707-980-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 BLOSSOM HILL RD STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246350",
            "telephone_number": "408-528-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMPIN",
        "first_name": "MARIANO",
        "middle_name": "JERVOSO",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "52735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Rebecca Melman
• Leticia Melo, DH
• Eleonore Jade Melon-Drahon
• Melvin S. Hsu Chiropractic Inc.
• Evangeline Morales Memoracion, D.M.D
• Frank C Mems Jr.
• Lisa Mena
• Rudy Justin Mena
• Jacqueline Simone Menard, LCSW
• Margaret Belinda Menchaca, LVN

• Physical Therapy Assistant in San Jose, CA
• Providers in San Jose, 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 Mar 6, 2024; 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.