Healthcare Provider Details

I. General information

NPI: 1598739898
Provider Name (Legal Business Name): JAMIE LYNNETTE MASON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N VENTURA RD SUITE NUMBER 103
OXNARD CA
93030-3841
US

IV. Provider business mailing address

2296 CHELSEY CT
CAMARILLO CA
93010-1160
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0811
  • Fax: 805-983-1481
Mailing address:
  • Phone: 805-482-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 15595
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: