Active NPI
Jessica Tice, DPT
- Physical Therapist
- Oakland, CA
National Provider Identifier
1477966919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38541
- Practice address
- 3300 Webster St
703
Oakland, CA 94609-3117 - Phone
- (510) 835-5633
- NPI assigned
- Jun 3, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 38541 | CA | Primary |
Addresses
Primary practice location
3300 Webster St
703
Oakland, CA 94609-3117
Mailing address
9089 Clairemont Mesa Blvd
200
San Diego, CA 92123-1234
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 |
|---|---|---|---|
| 38541 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401753600000",
"number": "1477966919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9089 CLAIREMONT MESA BLVD",
"address_2": "200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 WEBSTER ST",
"address_2": "703",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093117",
"telephone_number": "510-835-5633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICE",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-03",
"last_updated": "2014-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "38541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.