Active NPI
Janice Y Date, PT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1952455461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT8171
- Practice address
- 11835 W Olympic Blvd Ste 135E
Suite 135E
Los Angeles, CA 90064-5047 - Phone
- (310) 401-6410
- Fax
- (310) 312-3637
- NPI assigned
- Jan 22, 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 | PT8171 | CA | Primary |
Addresses
Primary practice location
11835 W Olympic Blvd Ste 135E
Suite 135E
Los Angeles, CA 90064-5047
Mailing address
11835 W Olympic Blvd
Suite 135E
Los Angeles, CA 90064-5001
Phone (310) 401-6410
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8171 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475625600000",
"number": "1952455461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11835 W OLYMPIC BLVD",
"address_2": "SUITE 135E",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645001",
"telephone_number": "310-401-6410",
"fax_number": "310-312-3637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 W OLYMPIC BLVD STE 135E",
"address_2": "SUITE 135E",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900645047",
"telephone_number": "310-401-6410",
"fax_number": "310-312-3637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATE",
"first_name": "JANICE",
"middle_name": "Y",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2016-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT8171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.