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General NPI Number Information
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NPI Number | 1942457437
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Entity Type | Individual
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Provider Name | JENNY Y. COSCARELLI
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Gender | Female
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 707 SUNRISE AVE
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City | ROSEVILLE
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State | CA
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Zip | 95661-4524
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Country | US
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Telephone | 916-610-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 805 COTTONWOOD DR
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City | ROSEVILLE
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State | CA
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Zip | 95661-4719
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Country | US
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Telephone | 510-378-5656
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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 | 11742
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License Number State | CA
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