Provider Demographics
NPI:1275680308
Name:JESSICA HEIN PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:JESSICA HEIN PHYSICAL THERAPY, INC
Other - Org Name:IN STEP PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:LLACH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:661-328-9913
Mailing Address - Street 1:1800 WESTWIND DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3055
Mailing Address - Country:US
Mailing Address - Phone:661-328-9913
Mailing Address - Fax:661-328-9914
Practice Address - Street 1:1800 WESTWIND DR
Practice Address - Street 2:SUITE 403
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3055
Practice Address - Country:US
Practice Address - Phone:661-328-9913
Practice Address - Fax:661-328-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185462251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT185460Medicare ID - Type Unspecified