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General NPI Number Information
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NPI Number | 1568520989
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Entity Type | Individual
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Provider Name | JAN M RICHARDS PT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 568 N SUNRISE AVE STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-3097
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Country | US
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Telephone | 916-865-1100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 15359
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License Number State | CA
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