Provider Demographics
NPI:1376681023
Name:JEPPESEN, ANN ELIZABETH (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:ELIZABETH
Last Name:JEPPESEN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2550 ABERDEEN LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5656
Mailing Address - Country:US
Mailing Address - Phone:916-941-1501
Mailing Address - Fax:916-941-7589
Practice Address - Street 1:4919 WINDPLAY DR
Practice Address - Street 2:SUITE 4
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9621
Practice Address - Country:US
Practice Address - Phone:916-939-6800
Practice Address - Fax:916-939-6874
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist