Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 8975 | CA |
NPI | 1013306000 |
---|---|
Provider Name | Tammy Lynn Jakobs |
First Address | Rancho Cordova, CA 95670-3122 |
Second Address | Rancho Cordova, CA 95670-3122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2015 |
Last Update Date | 14/01/2015 |