Provider Demographics
NPI:1174864524
Name:WERNER, JENNIFER BRITTNY (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRITTNY
Last Name:WERNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 BALTIMORE DR APT 101
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-6501
Mailing Address - Country:US
Mailing Address - Phone:619-410-7169
Mailing Address - Fax:
Practice Address - Street 1:4949 BALTIMORE DR APT 101
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-6501
Practice Address - Country:US
Practice Address - Phone:619-410-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011882A225100000X
CAPT40005225100000X
CA3027202251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics