Sol Johanna Jaque, PTA
NPI 1750153615ActiveIndividual· Physical Therapy Assistant· Lake Havasu City, AZ
Physical Therapy Assistant (PTA) in Lake Havasu City, Arizona, licensed in AZ, with an NPI issued in October 2023.
Overview
| NPI | 1750153615 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | No |
| NPI issued | Oct 24, 2023 |
| Last updated in NPPES | Oct 24, 2023 |
| Certified by provider | Oct 24, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | PTA-014722 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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