Jaclyn Jean Tolentino, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A16308 Issued in CA

Practice address

740 S Pacific Coast Hwy
El Segundo, CA 90245-4717

Phone

(310) 563-7366

NPI assigned

Sep 11, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 20, 2018 through Nov 20, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: jaclyn.tolentino.1@28372.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1609201417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FOWLING ST",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937729",
            "telephone_number": "305-458-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S PACIFIC COAST HWY",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454717",
            "telephone_number": "310-563-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "JACLYN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2024-05-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A16308",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS12358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reuel Tizabi, PT, DPT
• Julieann To
• Leslie Tobias, MPT
• Scott Tobis
• Thomas T Togioka, M.D.
• Kianna Toliver
• Maria Tomas
• Olivia Tomaselli
• Blessamarie K Tomita
• Maia Tonoukouin

• Family Medicine Physician in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.