Individual provider Active NPI

Sediah Jaleiba, PTA,CLT

  • Community Health Worker
  • Port St Lucie, FL
National Provider Identifier
1841507381
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
20455 Issued in FL
Practice address
2813 Slice CT
Port St Lucie, FL 34952-3184
Phone
(703) 798-1599
Fax
(866) 221-7925
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 20455 FL Primary

Addresses

Primary practice location

2813 Slice CT
Port St Lucie, FL 34952-3184

Mailing address

2813 Slice CT
Port St Lucie, FL 34952-3184
Phone (703) 798-1599

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

LicenseStateTypeSpecialty
20455FLMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1841507381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 SLICE CT",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523184",
            "telephone_number": "703-798-1599",
            "fax_number": "866-221-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 SLICE CT",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523184",
            "telephone_number": "703-798-1599",
            "fax_number": "866-221-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALEIBA",
        "first_name": "SEDIAH",
        "name_prefix": "Mrs.",
        "credential": "PTA,CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "20455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.