Jaclyn Sloboda, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38004 Issued in CA

Practice address

2222 Pico Blvd #102
Santa Monica, CA 90405

Phone

(800) 507-2634

Fax

(310) 774-3652

NPI assigned

Jan 19, 2012

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.

• Yvette Flores Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Santa Monica, CA
  • NPI 1134351232
  NPD (past)

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1831460062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3524",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90408",
            "telephone_number": "800-507-2634",
            "fax_number": "310-774-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 PICO BLVD #102",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90405",
            "telephone_number": "800-507-2634",
            "fax_number": "310-774-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOBODA",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT38004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skypark Physical Therapy Inc
• Justin James Slade, M.D.
• Susan Harper Slate
• Gabrielle Margaret Slater, MA
• Alison Young Sleight, M.S, OTR/L
• Svetlana Slocum, MD
• Ira Smalberg, MD
• Nicole Whitney Small
• Smart Brain and Health Inc
• Smart Heart & Health

• Physical Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.