Provider Demographics
NPI:1407391808
Name:CHAVARRIA, JESSICA STEMLER (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:STEMLER
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:HELEN
Other - Last Name:STEMLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4019 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2401
Mailing Address - Country:US
Mailing Address - Phone:619-988-9926
Mailing Address - Fax:
Practice Address - Street 1:3959 RUFFIN RD STE J
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1830
Practice Address - Country:US
Practice Address - Phone:858-279-5570
Practice Address - Fax:858-279-5303
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 292351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist