Active NPI
Jeannette Dileo, PTA
- Physical Therapy Assistant
- Lodi, CA
National Provider Identifier
1801311337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT6474
- Practice address
- 800 S Ham LN
Lodi, CA 95242-3543 - Phone
- (209) 368-7141
- NPI assigned
- Aug 5, 2017
- 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 | AT6474 | CA | Primary |
Addresses
Primary practice location
800 S Ham LN
Lodi, CA 95242-3543
Mailing address
2904 White Oak Way
Lodi, CA 95242-2034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT6474 | Other | CA | PHYSICAL THERAPY BOARD OF CALIFORNIA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT6474 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501891200000",
"number": "1801311337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2904 WHITE OAK WAY",
"city": "LODI",
"state": "CA",
"postal_code": "952422034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S HAM LN",
"city": "LODI",
"state": "CA",
"postal_code": "952423543",
"telephone_number": "209-368-7141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILEO",
"first_name": "JEANNETTE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-05",
"last_updated": "2017-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT6474",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
"identifier": "AT6474",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.