Active NPI
Jade Bisconer
- Recreation Therapist
- Tulare, CA
National Provider Identifier
1669297586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- Practice address
- 120 N M St
Tulare, CA 93274-4137 - Phone
- (559) 510-6460
- NPI assigned
- Nov 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dance Therapist | 225600000X | |||
| Recreation Therapist | 225800000X | Primary |
Addresses
Primary practice location
120 N M St
Tulare, CA 93274-4137
Mailing address
120 N M St
Tulare, CA 93274-4137
Phone (559) 510-6460
Other names 1
- Jade Brink
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": "1731628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1669297586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 N M ST",
"city": "TULARE",
"state": "CA",
"postal_code": "932744137",
"telephone_number": "559-510-6460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N M ST",
"city": "TULARE",
"state": "CA",
"postal_code": "932744137",
"telephone_number": "559-510-6460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISCONER",
"first_name": "JADE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-15",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225600000X",
"taxonomy_group": "",
"desc": "Dance Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JADE",
"last_name": "BRINK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tulare, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.