Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Prince

Individual provider Physical Therapist · NPI 1376358671

Jack Prince is a Physical Therapist in Private Practice in Cupertino, California. Qualified in 2024, 2 years ago. Practices with Southern Mono Health Care District, a 94-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2025
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Practice location Address checks out

20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112
Phone: (408) 252-6076
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 307349 (CA)

Record details

NPI number1376358671
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 12, 2025
Last updated in NPPESFebruary 12, 2025
Certification dateFebruary 12, 2025
Mailing address20823 Stevens Creek Blvd Ste 200, Cupertino, CA 95014-2112

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Southern Mono Health Care District — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cupertino