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NPI Code Detail

MEDICARE: JENNIFER NELSON P.T.

MEDICARE: JENNIFER NELSON P.T.
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
1225100000XPhysical TherapistPT22841CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT22841OTHERCALICENSE

General Provider Information

NPI Number : 1346389996
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NELSON P.T.
Provider Business Mailing Address
First Line : 2044 GOODWIN AVE
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94061-2502
Country : US
Telephone Number : 650-565-8090
Fax Number : 650-565-8095
Provider Business Practice Location Address
First Line : 2450 EL CAMINO REAL STE 101
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-1706
Country : US
Telephone Number : 650-565-8090
Fax Number : 650-565-8095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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Directions to “ JENNIFER NELSON P.T.” Practice Location

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