Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 40QA01201900 | NJ |
Y | 2251G0304X | Physical Therapist - Geriatrics | 38372 | CA |
NPI | 1407955560 |
---|---|
Provider Name | Jaclyn Muller |
First Address | Sunnyvale, CA 94086-5868 |
Second Address | Sunnyvale, CA 94086-5868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 11/01/2013 |