Active NPI
Jehan Rigor Mangondato, PT
- Physical Therapist
- San Francisco, CA
National Provider Identifier
1891828463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 28355
- Practice address
- 375 Laguna Honda Blvd
Laguna Honda Hospital, Physical Therapy Dept.
San Francisco, CA 94116-1411 - Phone
- (415) 759-4520
- Fax
- (415) 759-6317
- NPI assigned
- Mar 13, 2007
- 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 Therapist | 225100000X | PT 28355 | CA | Primary |
Addresses
Primary practice location
375 Laguna Honda Blvd
Laguna Honda Hospital, Physical Therapy Dept.
San Francisco, CA 94116-1411
Mailing address
375 Laguna Honda Blvd
Laguna Honda Hospital, Physical Therapy Dept.
San Francisco, CA 94116-1411
Phone (415) 759-4520
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 28355 | Other | CA | CA BOARD OF PT |
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 |
|---|---|---|---|
| PT 28355 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891828463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 LAGUNA HONDA BLVD",
"address_2": "LAGUNA HONDA HOSPITAL, PHYSICAL THERAPY DEPT.",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941161411",
"telephone_number": "415-759-4520",
"fax_number": "415-759-6317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 LAGUNA HONDA BLVD",
"address_2": "LAGUNA HONDA HOSPITAL, PHYSICAL THERAPY DEPT.",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941161411",
"telephone_number": "415-759-4520",
"fax_number": "415-759-6317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGONDATO",
"first_name": "JEHAN",
"middle_name": "RIGOR",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 28355",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA BOARD OF PT",
"identifier": "PT 28355",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.