NPIMap

Organization Active NPI

Telly Jaya Transportation, LLC

  • Non-emergency Medical Transport (VAN)
  • Palmdale, CA
National Provider Identifier
1629545561
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
TELLY JAYA TRANSPORTATION, LLC
Practice address
190 Sierra CT.
Unit B # a-115
Palmdale, CA 93550-7607
Phone
(661) 886-0285
Fax
(661) 213-9733
NPI assigned
Oct 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Authorized official

Name
Sanjaya Satriya UtamaNPI 1922408756
Title
Manager
Phone
(661) 886-0287

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

190 Sierra CT.
Unit B # a-115
Palmdale, CA 93550-7607

Mailing address

190 Sierra CT.
Unit B # a-115
Palmdale, CA 93550-7607
Phone (661) 886-0287

National Provider Directory

National Provider Directory

Locations

190 Sierra Ct
Unit B
Palmdale, CA 93550
Phone (661) 886-0285

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1629545561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SIERRA CT.",
            "address_2": "UNIT B # A-115",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507607",
            "telephone_number": "661-886-0287",
            "fax_number": "661-213-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SIERRA CT.",
            "address_2": "UNIT B # A-115",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507607",
            "telephone_number": "661-886-0285",
            "fax_number": "661-213-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELLY JAYA TRANSPORTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "UTAMA",
        "authorized_official_first_name": "SANJAYA",
        "authorized_official_middle_name": "SATRIYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "661-886-0287"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.