Individual provider Active NPI

Jonah Gabriel Maranon, PTA

  • Physical Therapy Assistant
  • Pleasanton, CA
National Provider Identifier
1710668728
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
52666 Issued in CA
Practice address
4626 Willow Rd
Pleasanton, CA 94588-8517
Phone
(925) 463-0470
NPI assigned
Jul 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 52666 CA Primary

Addresses

Primary practice location

4626 Willow Rd
Pleasanton, CA 94588-8517

Mailing address

2247 Normandy Cir
Livermore, CA 94550-8226
Phone (925) 337-6284

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1710668728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 NORMANDY CIR",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945508226",
            "telephone_number": "925-337-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888517",
            "telephone_number": "925-463-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARANON",
        "first_name": "JONAH",
        "middle_name": "GABRIEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "52666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.