Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT11079 | CA |
NPI | 1003117110 |
---|---|
Provider Name | Ms. Christine A Jones |
First Address | Santa Rosa Valley, CA 93012-9339 |
Second Address | Santa Rosa Valley, CA 93012-9339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2010 |
Last Update Date | 04/11/2010 |