Provider Demographics
NPI:1306385315
Name:GARNER, JANENE (DPT)
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:
Last Name:GARNER
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 1:247 4TH ST APT 404
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4327
Mailing Address - Country:US
Mailing Address - Phone:510-376-0206
Mailing Address - Fax:
Practice Address - Street 1:30116 EIGENBRODT WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1225
Practice Address - Country:US
Practice Address - Phone:510-675-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist