Mayra Lupe Jacobo

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

93768 Issued in CA

Practice address

17906 Pioneer Blvd Ste 101-102
Artesia, CA 90701-3972

Phone

(562) 865-2222

NPI assigned

Dec 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optimum Care Physical Therapy Services

  dba Optimum Care Therapy

  • Physical Therapy Clinic/Center
  • Artesia, CA
  • NPI 1700215316
  NPD

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1659149292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17906 PIONEER BLVD STE 101-102",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013972",
            "telephone_number": "562-865-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17906 PIONEER BLVD STE 101-102",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013972",
            "telephone_number": "562-865-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "MAYRA",
        "middle_name": "LUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "93768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tzong-Yueh Hwang, M.D.
• Amanche Ndonwa Ibe, DDS
• Bryan Takanori Imoto, BRYAN IMOTO O.D.
• Ken Imoto, OD
• Ken Iwaki, D.C.
• Arash Jahanbakhsh, DMD
• Anasuyaben Dahyalal Jani, NP
• Michael Tuazon Jarvina
• Mahtab Javed Siddiqui
• Jenymel's Home

• Massage Therapist in Artesia, CA
• Providers in Artesia, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.