Jessica Lorraine Van Soest

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

293825 Issued in CA

Practice address

2450 Washington Ave
San Leandro, CA 94577-5996

Phone

(510) 577-0777

NPI assigned

Oct 6, 2017

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Physical Therapy PCGroup PAC ID 6406022078, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Renew Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Novato, CA
  • NPI 1255508453

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1760992531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 BOULEVARD WAY",
            "address_2": "STE 2D",
            "city": "PIEDMONT",
            "state": "CA",
            "postal_code": "946101563",
            "telephone_number": "510-922-8872",
            "fax_number": "510-291-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 WASHINGTON AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775996",
            "telephone_number": "510-577-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SOEST",
        "first_name": "JESSICA",
        "middle_name": "LORRAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Valmana Lastres
• Katherine Kyoko Valois, M.D.
• Thomas Vamvouris, DC
• Turnip Alana Mystery Van Dyke
• Aniek Van Ham-Iotov, RN
• Skylar Vanauken
• Susie P Vanbuskirk, BA, BS, LMFT
• Clay Vance
• Bernadette Patricia Vandeusen, MSN, APRN, FNP-C
• Laurine Kinza Vanlerberg, PMHNP, FNP

• Physical Therapist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.