Individual provider Active NPI

Jessica Peterson, DPT

  • Pediatric Physical Therapist
  • Redlands, CA
National Provider Identifier
1659296507
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
310673 Issued in CA
Practice address
10431 Commerce St Ste a
Redlands, CA 92374-0110
Phone
(909) 735-7654
NPI assigned
Aug 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 310673 CA Primary

Addresses

Primary practice location

10431 Commerce St Ste a
Redlands, CA 92374-0110

Mailing address

10431 Commerce St Ste a
Redlands, CA 92374-0110
Phone (909) 735-7654

Other names 1

  • Jessica Landreth Former name

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": "1786406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1659296507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10431 COMMERCE ST STE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923740110",
            "telephone_number": "909-735-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 COMMERCE ST STE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923740110",
            "telephone_number": "909-735-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "310673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LANDRETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.