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General NPI Number Information
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NPI Number | 1063519726
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Entity Type | Individual
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Provider Name | JARED VAN DER BEEK P.T.
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Gender | Male
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 1801 BUSH ST LOWR LEVEL
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-5239
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Country | US
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Telephone | 415-763-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 1A WAINWRIGHT PL
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City | MILL VALLEY
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State | CA
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Zip | 94941-5034
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Country | US
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Telephone | 415-763-5523
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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 | QA009772
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016150
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 13995
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 33779
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License Number State | CA
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