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NPI Code Detail

MEDICARE: NATASHA CARRIEDO-JAIME PT, DPT

MEDICARE:   NATASHA  CARRIEDO-JAIME  PT, 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
1225100000XPhysical Therapist294412CA

General Provider Information

NPI Number : 1821659137
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA CARRIEDO-JAIME PT, DPT
Provider Business Mailing Address
First Line : 30 N MADISON AVE UNIT 421
Second Line :
City : PASADENA
State : CA
Zip : 91101-4541
Country : US
Telephone Number : 951-529-5944
Fax Number :
Provider Business Practice Location Address
First Line : 30 N MADISON AVE UNIT 421
Second Line :
City : PASADENA
State : CA
Zip : 91101-4541
Country : US
Telephone Number : 951-529-5944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2019
Last Update Date : 12/29/2021

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Directions to “ NATASHA CARRIEDO-JAIME PT, DPT” Practice Location

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