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General NPI Number Information
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NPI Number | 1003010240
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Entity Type | Individual
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Provider Name | JILL M WERNER B.SC.P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1720 CESAR E CHAVEZ AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-268-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 11411 OHIO AVE APT. 15
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City | LOS ANGELES
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State | CA
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Zip | 90025-3158
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Country | US
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Telephone | 310-862-4570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 30414
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License Number State | CA
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