Active NPI
Stephanie Wen
- Physical Therapy Assistant
- Belmont, CA
National Provider Identifier
1912489139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA49445
- Practice address
- 540 Ralston Ave Ste B
Belmont, CA 94002-2866 - Phone
- (650) 363-5668
- Fax
- (650) 363-5669
- NPI assigned
- Sep 4, 2018
- 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 | PTA49445 | CA | Primary |
Addresses
Primary practice location
540 Ralston Ave Ste B
Belmont, CA 94002-2866
Mailing address
2450 Walters Way Apt 16
Concord, CA 94520-3668
Phone (925) 448-5327
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 |
|---|---|---|---|
| PTA49445 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1912489139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 WALTERS WAY APT 16",
"city": "CONCORD",
"state": "CA",
"postal_code": "945203668",
"telephone_number": "925-448-5327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 RALSTON AVE STE B",
"city": "BELMONT",
"state": "CA",
"postal_code": "940022866",
"telephone_number": "650-363-5668",
"fax_number": "650-363-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEN",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "PTA49445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.