MEDICARE: ABILITY PHYSICAL THERAPY SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	36408	CA

General Provider Information

NPI Number	:	1942706445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILITY PHYSICAL THERAPY SERVICES, INC.

Provider Business Mailing Address
First Line	:	5356 PRINCE ESTATES CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1368
Country	:	US
Telephone Number	:	408-659-6105
Fax Number	:

Provider Business Practice Location Address
First Line	:	5356 PRINCE ESTATES CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1368
Country	:	US
Telephone Number	:	408-659-6105
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANJANETTE LIM JAVELLANA
Credential	:	PT
Telephone Number	:	408-659-6105

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	04/03/2018

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