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

Jonathan Waggonner, PTA, CMT

Individual provider Massage Therapist · NPI 1962201558

Jonathan Waggonner, PTA, CMT is a Massage Therapist in Redlands, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1455 W Park Ave
Redlands, CA 92373-8178
Phone: (909) 793-2225
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X (CA)

Record details

NPI number1962201558
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA , CMT
Sole proprietorNo
NPI enumeratedMarch 7, 2025
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address1455 W Park Ave, Redlands, CA 92373-8178

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