Active NPI
Mary Jill Jackson, PT, DPT
- Physical Therapist
- Pleasanton, CA
National Provider Identifier
1962620021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 32473
- Practice address
- 5000 Hopyard Rd
220
Pleasanton, CA 94588-3348 - Phone
- (800) 493-2988
- NPI assigned
- Apr 23, 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 | 32473 | CA | Primary |
Addresses
Primary practice location
5000 Hopyard Rd
220
Pleasanton, CA 94588-3348
Mailing address
1546 Haviland PL
Clayton, CA 94517-1049
Phone (970) 222-5898
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 |
|---|---|---|---|
| 32473 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962620021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1546 HAVILAND PL",
"city": "CLAYTON",
"state": "CA",
"postal_code": "945171049",
"telephone_number": "970-222-5898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 HOPYARD RD",
"address_2": "220",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945883348",
"telephone_number": "800-493-2988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MARY",
"middle_name": "JILL",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "32473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, 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.