MR. JASON SCOTT WALLACE (NPI# 1891786646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891786646 |
| Entity Type | Individual |
| Full Name | MR. JASON SCOTT WALLACE |
| Credential | PTA |
| Practice Address |
2486 N Ponderosa Dr Ste D-106 Camarillo CA 93010-2376 |
| Mailing Address |
4979 Burson Way Oxnard CA 93036-1017 |
| Practice Telephone | 8054845447 |
| Mailing Telephone | 8056715625 |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | AT5146 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755638 | Jason David Wallace | Nurse Practitioner | 2616 Gallaway Cv, Jonesboro, AR 72404-7827 | 2020-06-22 |
| 1346698842 | Jason Wallace | Dentist | 1400 W Covell Rd, Edmond, OK 73003-3504 | 2016-05-25 |
| 1679713754 | Jason D Wallace | Behavioral Analyst | 104 Shoreview Ln, Oldsmar, FL 34677-4106 | 2009-03-02 |
| 1992020937 | Jason R Wallace | Family Medicine | 95 S Pagosa Blvd, Pagosa Springs, CO 81147-8329 | 2010-04-01 |
| 1689751166 | Jason Wallace | Optometrist | 502 Celebration Ave, Celebration, FL 34747-4687 | 2006-11-01 |
| 1013028612 | Jason R. Wallace | Radiology | 12554 Riata Vista Circle, Austin, TX 78727-6432 | 2006-08-31 |
| Street Address |
2486 N PONDEROSA DR STE D-106 |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-2376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497758171 | William Douglas Bocash | Pediatrics | 2486 N Ponderosa Dr, Ste D211, Camarillo, CA 93010-2376 | 2005-05-24 |
| 1346785649 | Orthopedic and Spine Institute of Southern California, Inc. | Orthopaedic Surgery | 2486 N Ponderosa Dr, Ste D114, Camarillo, CA 93010-2376 | 2016-12-23 |
| 1053863654 | Christina Velasco | Nurse Practitioner | 2486 N Ponderosa Dr, Ste D114, Camarillo, CA 93010-2469 | 2016-10-30 |
| 1487904397 | Pamela Elizabeth Mikita | Physical Therapy Assistant | 2486 N Ponderosa Dr, Camarillo, CA 93010-2376 | 2012-09-18 |
| 1841456118 | Herbert W Percival Md A Prof Corp | Orthopaedic Surgery | 2486 N Ponderosa Dr, Ste D 114, Camarillo, CA 93010-2376 | 2008-08-05 |
| 1285810762 | Jodi Christine Ferro | Obstetrics & Gynecology | 2486 N Ponderosa Dr, Camarillo, CA 93010-2376 | 2008-01-15 |
| 1013191253 | Ventura County Gastroenterology Medical Group | Internal Medicine | 2486 N Ponderosa Dr, Suite D-206, Camarillo, CA 93010-2376 | 2007-12-24 |
| 1467506907 | Spencer Eye Surgery and Laser Center | Clinic/Center | 2486 N Ponderosa Dr, Suite D110, Camarillo, CA 93010-2376 | 2007-01-22 |
| 1942372909 | Jon H Williams | Podiatrist | 2486 N Ponderosa Dr, Suite D-100, Camarillo, CA 93010-2376 | 2006-11-14 |
| 1255415212 | Tanya Louise Masako Behl | Physical Therapist | 2486 N Ponderosa Dr, Suite D-106, Camarillo, CA 93010-2376 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| 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 |
|---|---|---|---|---|
| 1578020343 | Jennifer Lynn Line | Physical Therapy Assistant | 1269 Palmer Ave, Camarillo, CA 93010-3342 | 2019-02-27 |
| 1629511795 | Benjamin Tolosa | Physical Therapy Assistant | 2485 Woodcreek Rd, Camarillo, CA 93012-2537 | 2016-11-22 |
| 1831642826 | Dallas Miller | Physical Therapy Assistant | 288 Lightwood St, Camarillo, CA 93012-7752 | 2016-07-26 |
| 1194985184 | Joseph Tupas Marcella | Physical Therapy Assistant | 1925 Del Ciervo Pl, Camarillo, CA 93012-4067 | 2008-06-12 |
| 1154863785 | Antonio Escudero | Physical Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-14 |
| 1811439698 | Philip Samaniego | Physical Therapy Assistant | 205 Granada St, Camarillo, CA 93010-7715 | 2016-11-10 |
| 1164859674 | Jaclyn Michelle Salle | Physical Therapy Assistant | 231 Camarillo Ranch Rd, Camarillo, CA 93012-5082 | 2013-09-28 |
| 1689918880 | Karen F Burg | Physical Therapy Assistant | 6000 Santa Rosa Rd, Camarillo, CA 93012-7101 | 2012-11-12 |
| 1487904397 | Pamela Elizabeth Mikita | Physical Therapy Assistant | 2486 N Ponderosa Dr, Camarillo, CA 93010-2376 | 2012-09-18 |
| 1730461922 | Jeffrey Don Horrocks | Physical Therapy Assistant | 231 Camarillo Ranch Rd, Camarillo, CA 93012-5082 | 2011-09-13 |
| Find all providers in CAMARILLO | ||||
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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.