Provider Demographics
NPI:1437221199
Name:VONARB, JENNIFER LEE (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:VONARB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E THOUSAND OAKS BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5761
Mailing Address - Country:TC
Mailing Address - Phone:805-497-9300
Mailing Address - Fax:805-497-9311
Practice Address - Street 1:90 E THOUSAND OAKS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5761
Practice Address - Country:US
Practice Address - Phone:805-341-7110
Practice Address - Fax:805-497-9311
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14444225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT14444BMedicare ID - Type UnspecifiedPPIN
CAW17180Medicare ID - Type UnspecifiedGROUP ID