Individual provider Active NPI

Juliana Evans-Anfom, DPT

  • Physical Therapist
  • Berkeley, CA
National Provider Identifier
1750003703
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302881 Issued in CA
Practice address
2100 San Pablo Ave
Berkeley, CA 94702-1828
Phone
(510) 788-1333
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 302881 CA Primary

Addresses

Primary practice location

2100 San Pablo Ave
Berkeley, CA 94702-1828

Mailing address

560 53Rd St
Oakland, CA 94609-1932

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
302881CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabcare Group East, LLC PastSince Sep 20, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1750003703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 53RD ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SAN PABLO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947021828",
            "telephone_number": "510-788-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS-ANFOM",
        "first_name": "JULIANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.