MEDICARE: MRS. JENNIFER MAHLER GAMBOA PT, DPT, OCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT2733	DC
2	2251X0800X	Orthopedic Physical Therapist	2305005274	VA
3	225100000X	Physical Therapist	2305005274	VA

General Provider Information

NPI Number	:	1265644538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER MAHLER GAMBOA PT, DPT, OCS

Provider Business Mailing Address
First Line	:	408 HIGUERA ST STE 200
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-6135
Country	:	US
Telephone Number	:	805-788-0805
Fax Number	:	805-788-0845

Provider Business Practice Location Address
First Line	:	410 S MAPLE AVE STE 100
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4246
Country	:	US
Telephone Number	:	703-988-6010
Fax Number	:	703-526-0430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	01/26/2024

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1558337758 — JORGE VILLALOBOS-SOLANO PT, DPT
Practice Location Address:

410 S MAPLE AVE STE 100
FALLS CHURCH, VA
22046-4246

Practice Phone: 703-988-6010
Practice Fax: 703-526-0430

1619944576 — DEBORAH LEE GILPIN PT, DPT, AT, C
Practice Location Address:

410 S MAPLE AVE STE 100
FALLS CHURCH, VA
22046-4246

Practice Phone: 703-988-6010
Practice Fax: 703-526-0430

1871705152 — MRS. ASHLEY LANCASTER TEMPLER PT
Practice Location Address:

410 S MAPLE AVE STE 100
FALLS CHURCH, VA
22046-4246

Practice Phone: 703-988-6010
Practice Fax: 703-526-0430

1881872521 — SUSAN J RYERSON P.T., SCD
Practice Location Address:

410 S MAPLE AVE , SUITE 102
FALLS CHURCH, VA
22046-4246

Practice Phone: 703-370-2970
Practice Fax:

1750790283 — LISA CLARKSON
Practice Location Address:

410 S MAPLE AVE STE 100
FALLS CHURCH, VA
22046-4246

Practice Phone: 703-988-6010
Practice Fax: 703-526-0430

Directions to “ MRS. JENNIFER MAHLER GAMBOA PT, DPT, OCS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.