Active NPI
Ysel Jelle Ganda, DC
- Chiropractor
- Fremont, CA
National Provider Identifier
1487124673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34351
- Practice address
- 3769 Peralta Blvd.
Suite H
Fremont, CA 94536 - Phone
- (415) 799-1693
- NPI assigned
- Nov 29, 2018
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 34351 | CA | Primary |
Addresses
Primary practice location
3769 Peralta Blvd.
Suite H
Fremont, CA 94536
Mailing address
3769 Peralta Blvd.
Suite H
Fremont, CA 94536
Phone (415) 799-1693
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 |
|---|---|---|---|
| 34351 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1487124673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3769 PERALTA BLVD.",
"address_2": "SUITE H",
"city": "FREMONT",
"state": "CA",
"postal_code": "94536",
"telephone_number": "415-799-1693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3769 PERALTA BLVD.",
"address_2": "SUITE H",
"city": "FREMONT",
"state": "CA",
"postal_code": "94536",
"telephone_number": "415-799-1693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDA",
"first_name": "YSEL",
"middle_name": "JELLE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-29",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "CA",
"license": "34351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.