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NPI Code Detail

MEDICARE: JENNIFER JAEGER

MEDICARE: JENNIFER JAEGER
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
1225100000XPhysical TherapistPT30050CA

General Provider Information

NPI Number : 1134199326
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JAEGER
Provider Business Mailing Address
First Line : PO BOX 1833
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95061-1833
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1529 SEABRIGHT AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-2528
Country : US
Telephone Number : 831-458-6230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 07/08/2007

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