Jay Pichika

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

306003893 Issued in CA

Practice address

203 Calle del Juego
San Clemente, CA 92672-2101

Phone

(949) 573-3964

Fax

(949) 940-8054

NPI assigned

Apr 12, 2024

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1669226007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 CALLE DEL JUEGO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926722101",
            "telephone_number": "949-573-3964",
            "fax_number": "949-940-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 CALLE DEL JUEGO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926722101",
            "telephone_number": "949-573-3964",
            "fax_number": "949-940-8054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Talega Terrace Care Facility",
            "address_2": "24 Via Andaremos",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "92673",
            "country_code": "US",
            "telephone_number": "949-573-3964",
            "fax_number": "949-940-8054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICHIKA",
        "first_name": "JAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CA",
            "license": "306003893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Makenna Phillips, CF-SLP
• PHS San Clemente, Inc.
• Physician Nutraceutical Research, Inc
• Briana Pica, PT, DPT
• Emelia Rose Piccininni, OTD, OTR/L
• Ashton Pickle, DPT
• Kenneth B. Pierce, D.O.
• Juliette Carol Louise Pineda, LMFT
• Pinnacle Wound Care
• Pioneer Orthotics and Prosthetics

• Assisted Living Facility (Mental Illness) in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Assisted Living Facility (Mental Illness) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.