Healthcare Provider Details

I. General information

NPI: 1346951431
Provider Name (Legal Business Name): BIG STEPS PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 BALTIMORE DRIVE #101
LA MESA CA
91942
US

IV. Provider business mailing address

4949 BALTIMORE DRIVE #101
LA MESA CA
91942
US

V. Phone/Fax

Practice location:
  • Phone: 619-410-7169
  • Fax:
Mailing address:
  • Phone: 619-410-7169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER WERNER
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 619-410-7169