Janeen E. Wallace, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

37914 Issued in CA

Practice address

5050 El Camino Real
Suite 210
Los Altos, CA 94022-1530

Phone

(650) 559-0011

Fax

(650) 559-0012

NPI assigned

Jul 20, 2011

Sex

Female

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)

Enrolled

State licenses

Practice roles

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.

• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Sunnyvale, CA
  • NPI 1053320325
  NPD (past)

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1750679056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 EL CAMINO REAL",
            "address_2": "SUITE 210",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221530",
            "telephone_number": "650-559-0011",
            "fax_number": "650-559-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 EL CAMINO REAL",
            "address_2": "SUITE 210",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221530",
            "telephone_number": "650-559-0011",
            "fax_number": "650-559-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JANEEN",
        "middle_name": "E.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siavosh Vossough, M.D.
• Elinor Eugenia Wahrmann, LMFT
• Yolanda Wai
• Walgreen Co
• Edna Wallace, LMFT
• Molly A Walsh, PH.D.
• Andrea Wang-Rockwell, LMFT
• Annie Wang, L.AC.
• Chung-Yun Corrine Wang, N.D.
• Jen Ching Wang

• Physical Therapist in Los Altos, CA
• Providers in Los Altos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.