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General NPI Number Information
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NPI Number | 1396236675
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Entity Type | Individual
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Provider Name | JENA KATHERINE GIARDINI PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 2365 NORTHSIDE DR STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92108-2710
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Country | US
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Telephone | 619-804-3009
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Fax |
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Provider Business Mailing Address
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Address Line | 8105 BAKER RD
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City | FRANKENMUTH
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State | MI
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Zip | 48734-9721
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Country | US
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Telephone | 989-493-9024
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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 | 5501018680
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License Number State | MI
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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 | PT-6443
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 296619
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License Number State | CA
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