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General NPI Number Information
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NPI Number | 1871802298
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Entity Type | Individual
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Provider Name | JAMIE M STANISZEWSKI P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 7700 EDGEWATER DR SUITE 225
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City | OAKLAND
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State | CA
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Zip | 94621-3030
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Country | US
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Telephone | 510-638-8033
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 EDGEWATER DR SUITE 225
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City | OAKLAND
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State | CA
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Zip | 94621-3030
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Country | US
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Telephone | 414-839-1720
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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 | 11552-024
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License Number State | WI
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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 | 37542
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License Number State | CA
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