Provider Demographics
NPI:1164856001
Name:VON DEN STEMMEN, JESSICA SARAH (MPT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:SARAH
Last Name:VON DEN STEMMEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2730 WILSHIRE BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4724
Mailing Address - Country:US
Mailing Address - Phone:805-777-7370
Mailing Address - Fax:805-777-7380
Practice Address - Street 1:1220 LA VENTA DR
Practice Address - Street 2:SUITE # 102
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3703
Practice Address - Country:US
Practice Address - Phone:805-777-7370
Practice Address - Fax:805-777-7380
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40402225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist