Active NPI
Laura Kathleen Forrest, PTA
- Physical Therapy Assistant
- San Jose, CA
National Provider Identifier
1689805434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5306
- Practice address
- 1267 Meridian Ave.
San Jose, CA 95125 - Phone
- (971) 206-5200
- Fax
- (971) 206-5203
- NPI assigned
- Jul 28, 2009
- Last updated
- Jul 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5306 | CA | Primary |
Addresses
Primary practice location
1267 Meridian Ave.
San Jose, CA 95125
Mailing address
4560 SE International Way, Ste 100
Milwaukie, OR 97222
Phone (971) 206-5200
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": "1248739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248739200000",
"number": "1689805434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY, STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1267 MERIDIAN AVE.",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95125",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORREST",
"first_name": "LAURA",
"middle_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-28",
"last_updated": "2009-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "5306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.