MEDICARE: CAMILLE ACEDO-JOUZEAU DPT

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	307816	CA

General Provider Information

NPI Number	:	1275333981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE ACEDO-JOUZEAU DPT

Provider Business Mailing Address
First Line	:	201 HOWARD ST APT 2
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-2764
Country	:	US
Telephone Number	:	628-842-7480
Fax Number	:

Provider Business Practice Location Address
First Line	:	6174 STATE FARM DR
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2135
Country	:	US
Telephone Number	:	707-586-4320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2025
Last Update Date	:	06/26/2026

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