Jennifer Ravely, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT8385 Issued in CA

Practice address

27299 Stonehurst Dr
Menifee, CA 92585-3419

Phone

(909) 772-3648

Fax

(951) 359-2096

NPI assigned

Sep 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1962871145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27299 STONEHURST DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925853419",
            "telephone_number": "909-772-3648",
            "fax_number": "951-359-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27299 STONEHURST DR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925853419",
            "telephone_number": "909-772-3648",
            "fax_number": "951-359-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVELY",
        "first_name": "JENNIFER",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT8385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rancho Oral and Facial Surgery of Menifee
• Rancho Physical Therapy, Inc.
• Yasiena Randolph
• Safeer Nehaal Rasul, DDS
• Evan M Ravely, PTA
• Anam Asif Raza, DMD
• Dylan Reaves
• Redford Menifee Dental Corporation
• Tamia Jade Redmon
• Silvia Reid, NP

• Physical Therapy Assistant in Menifee, CA
• Providers in Menifee, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.