MEDICARE: JON DENSING 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
1	225100000X	Physical Therapist	PT307733	CA

General Provider Information

NPI Number	:	1962290486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON DENSING PT, DPT

Provider Business Mailing Address
First Line	:	1307 S HARBOR BLVD UNIT 32
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92832-3001
Country	:	US
Telephone Number	:	657-243-8710
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 S HARBOR BLVD UNIT 32
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92832-3001
Country	:	US
Telephone Number	:	657-243-8710
Fax Number	:

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

Provider Enumeration Date	:	04/25/2025
Last Update Date	:	09/24/2025

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