MEDICARE: DR. JENNIFER SCHRECKENGAUST DPT

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	PT28840	CA

General Provider Information

NPI Number	:	1821033325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER SCHRECKENGAUST DPT

Provider Business Mailing Address
First Line	:	780 GARDEN VIEW CT
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2464
Country	:	US
Telephone Number	:	760-632-6942
Fax Number	:	760-632-6819

Provider Business Practice Location Address
First Line	:	780 GARDEN VIEW CT
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2464
Country	:	US
Telephone Number	:	760-632-6942
Fax Number	:	760-632-6819

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/08/2007

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