Provider Demographics
NPI:1346488913
Name:JENKINS, ERIN M (DPT, ATC/L)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DPT, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONARCH BAY PLZ
Mailing Address - Street 2:UNIT 196
Mailing Address - City:MONARCH BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3424
Mailing Address - Country:US
Mailing Address - Phone:949-208-2639
Mailing Address - Fax:949-861-9668
Practice Address - Street 1:14 MONARCH BAY PLZ
Practice Address - Street 2:UNIT 196
Practice Address - City:MONARCH BEACH
Practice Address - State:CA
Practice Address - Zip Code:92629-3424
Practice Address - Country:US
Practice Address - Phone:949-208-2639
Practice Address - Fax:949-861-9668
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52717174400000X
CA39476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist