Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 28944 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 28944 | CA |
N | 2251P0200X | Physical Therapist - Pediatrics | 28944 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 28944 | CA |
NPI | 1083755680 |
---|---|
Provider Name | Joscelyn C Washington |
First Address | Montclair, CA 91763-2358 |
Second Address | Montclair, CA 91763-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 28/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q59598 | (02) | CA |