Individual provider Active NPI

Jasmine PA Nou Ci Vang, PTA

  • Physical Therapy Assistant
  • Elk Grove, CA
National Provider Identifier
1982409587
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
53349 Issued in CA
Practice address
9281 Office Park Cir Ste 100
Elk Grove, CA 95758-8069
Phone
(916) 892-1330
Fax
(916) 892-1331
NPI assigned
Feb 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 53349 CA Primary

Addresses

Primary practice location

9281 Office Park Cir Ste 100
Elk Grove, CA 95758-8069

Mailing address

8908 Paulhaus Way
Elk Grove, CA 95758-8024

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

LicenseStateTypeSpecialty
53349CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1982409587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8908 PAULHAUS WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR STE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588069",
            "telephone_number": "916-892-1330",
            "fax_number": "916-892-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "JASMINE",
        "middle_name": "PA NOU CI",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.