Jesse Barretto Maico

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA49304 Issued in CA

Practice address

6080 Center Dr FL 6
Los Angeles, CA 90045-9205

Phone

(888) 859-0145

NPI assigned

Jul 2, 2018

Sex

Male

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

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1669968780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1295",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902941295",
            "telephone_number": "888-590-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 CENTER DR FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459205",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 W College St",
            "address_purpose": "LOCATION",
            "city": "Covina",
            "state": "CA",
            "postal_code": "917231902",
            "country_code": "US",
            "telephone_number": "626-967-7833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAICO",
        "first_name": "JESSE",
        "middle_name": "BARRETTO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA49304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuongvi Cung Mai
• Maia Montoya DDS Inc
• Flavio Pessoa de Melo Maia
• William Maia, RN
• Matthew Maibaum, PHD
• Eyal Maidan, M.D.
• Emanuel Maidenberg, PHD
• Karron Maidment, MFT
• Makaela Maier
• Michael Sulu Maiko Jr., LMFT

• Physical Therapy Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.