Active NPI
Jeneve Fern Kwan, PT
- Physical Therapist
- Anaheim, CA
National Provider Identifier
1508511197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29287
- Practice address
- 1780 W Lincoln Ave Apt 248
Anaheim, CA 92801-6756 - Phone
- (714) 988-5396
- NPI assigned
- Feb 13, 2022
- 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 | 29287 | CA | Primary |
Addresses
Primary practice location
1780 W Lincoln Ave Apt 248
Anaheim, CA 92801-6756
Mailing address
1780 W Lincoln Ave Apt 248
Anaheim, CA 92801-6756
Phone (714) 988-5396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230124000476 | CA | Practitioner - Physical Therapist in Private Practice | 0840661286 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644710400000",
"number": "1508511197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1780 W LINCOLN AVE APT 248",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928016756",
"telephone_number": "714-988-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 W LINCOLN AVE APT 248",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928016756",
"telephone_number": "714-988-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "JENEVE",
"middle_name": "FERN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-13",
"last_updated": "2022-02-13",
"certification_date": "2022-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "29287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.