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NPI 1487544631

NPI 1487544631 : ASHLEY JANTZEN LMT : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1487544631
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEY JANTZEN LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/08/2025
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    Last Update Date     |    07/08/2025
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Provider Practice Location Address
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    Address Line         |    3069 REYNARD WAY 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92103-5440
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    Country              |    US
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    Telephone            |    858-876-7080
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5211 CALLE ROCKFISH UNIT 91 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92154-6366
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    Country              |    US
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    Telephone            |    619-813-6407
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    26431
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    License Number State |    CA
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