Active NPI
Andrew Jaggon
- Physical Therapy Assistant
- Eastvale, CA
National Provider Identifier
1609654532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 51554
- Practice address
- 7131 Leighton Dr
Eastvale, CA 92880-3988 - Phone
- (805) 738-8236
- NPI assigned
- Sep 20, 2023
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 51554 | CA | Primary |
Addresses
Primary practice location
7131 Leighton Dr
Eastvale, CA 92880-3988
Mailing address
7131 Leighton Dr
Eastvale, CA 92880-3988
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1609654532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7131 LEIGHTON DR",
"city": "EASTVALE",
"state": "CA",
"postal_code": "928803988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7131 LEIGHTON DR",
"city": "EASTVALE",
"state": "CA",
"postal_code": "928803988",
"telephone_number": "805-738-8236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAGGON",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "51554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.