JETHRO PAYNE DE VEGA LA ROSA (NPI# 1720422983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720422983 |
| Entity Type | Individual |
| Full Name | JETHRO PAYNE DE VEGA LA ROSA |
| Practice Address |
39210 State St Suite 202 Fremont CA 94538-1456 |
| Practice Telephone | 5107909480 |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
39210 STATE ST SUITE 202 |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649272832 | David C Gorsulowsky | Specialist | 39210 State St, Ste 218, Fremont, CA 94538-1456 | 2005-06-01 |
| 1730713298 | Diana Velasco | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2020-02-24 |
| 1033758180 | Johnathan Shay | Chiropractor | 39210 State St, Fremont, CA 94538-1456 | 2020-01-06 |
| 1306483466 | Madina Halim | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2019-12-06 |
| 1548819535 | Errol Vinoya Tongco Jr. | Physical Therapy Assistant | 39210 State St, Fremont, CA 94538-1456 | 2019-09-11 |
| 1457912826 | Nancy Ruiz | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2019-06-25 |
| 1932679545 | Shandrina M Jardine | Behavior Technician | 39210 State St, Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1790255263 | Jhoann Nicole Lopez Batac | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2018-11-27 |
| 1780169003 | Mallory Holt | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2018-10-02 |
| 1942785514 | Brandon Nelson Icban | Behavioral Analyst | 39210 State St, Fremont, CA 94538-1456 | 2018-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 225200000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapy Assistant |
| (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient’s responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. |
| Notes: Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408630 | Daniel Datu Baculi | Physical Therapy Assistant | 38660 Lexington St Apt 588, Fremont, CA 94536-6201 | 2020-05-14 |
| 1518503481 | Anthony Joseph-lane White | Physical Therapy Assistant | 6601 S Luce Ave, Fremont, MI 49412-7389 | 2019-11-26 |
| 1891337739 | Madhuriben Godhani | Physical Therapy Assistant | 3909 Stevenson Blvd Apt 707, Fremont, CA 94538-2305 | 2019-10-11 |
| 1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
| 1831592559 | Christina Donelan Brent | Physical Therapy Assistant | 865 Old Canyon Rd, Fremont, CA 94536-1730 | 2014-10-08 |
| 1740605286 | Kaitlyn Light | Physical Therapy Assistant | 1649 Morrison Rd, Fremont, OH 43420-4855 | 2014-02-20 |
| 1275956120 | Paula Kenney | Physical Therapy Assistant | 29 Hall Rd, Fremont, NH 03044-3355 | 2014-01-29 |
| 1679844815 | Heather Lynn Sherwood | Physical Therapy Assistant | 4700 W 48th St, Fremont, MI 49412-7431 | 2012-01-19 |
| 1730467150 | Travis Owen Charter | Physical Therapy Assistant | 410 S Nye Ave, Fremont, NE 68025-5548 | 2011-08-02 |
| 1306124078 | Carol Ann Ness | Physical Therapy Assistant | 3210 N Clarkson St, Fremont, NE 68025-2301 | 2011-07-29 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.