Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT23848 | CA |
NPI | 1003031089 |
---|---|
Provider Name | Jenna M Sawdon-Bea |
First Address | Dublin, CA 94568-2787 |
Second Address | Dublin, CA 94568-2787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |