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General NPI Number Information
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NPI Number | 1013899608
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Entity Type | Individual
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Provider Name | JACQUELINE NARANJO-BERNABE PTA
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Gender | Female
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 212 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3135
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Country | US
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Telephone | 831-536-5115
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Fax | 831-233-3358
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Provider Business Mailing Address
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Address Line | 212 GREEN VALLEY RD
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City | FREEDOM
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State | CA
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Zip | 95019-3135
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 54191
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License Number State | CA
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