Individual provider Active NPI

Janice Y Date, PT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1952455461
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8171 Issued in CA
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

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PT8171CAMDPhysical 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.

Verify at the official NPI Registry.