Active NPI
Jeanne Underwood, PTA, ATC
- Physical Therapy Assistant
- Torrance, CA
National Provider Identifier
1902087299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT 3805
- Practice address
- 23430 Hawthorne Blvd
BLDG. 3, Suite 105
Torrance, CA 90505-4720 - Phone
- (310) 791-3812
- Fax
- (310) 373-4686
- NPI assigned
- Nov 15, 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 Therapy Assistant | 225200000X | AT 3805 | CA | Primary |
Addresses
Primary practice location
23430 Hawthorne Blvd
BLDG. 3, Suite 105
Torrance, CA 90505-4720
Mailing address
23430 Hawthorne Blvd
BLDG. 3, Suite 105
Torrance, CA 90505-4720
Phone (310) 791-3812
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 |
|---|---|---|---|
| AT 3805 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1902087299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23430 HAWTHORNE BLVD",
"address_2": "BLDG. 3, SUITE 105",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905054720",
"telephone_number": "310-791-3812",
"fax_number": "310-373-4686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23430 HAWTHORNE BLVD",
"address_2": "BLDG. 3, SUITE 105",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905054720",
"telephone_number": "310-791-3812",
"fax_number": "310-373-4686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "PTA, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT 3805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.