Provider Demographics
NPI:1447212311
Name:ADAMS, JAMIE LYNN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:LYNN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 ALLEGRO CT
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-1839
Mailing Address - Country:US
Mailing Address - Phone:805-610-7467
Mailing Address - Fax:
Practice Address - Street 1:805 AEROVISTA PL
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7919
Practice Address - Country:US
Practice Address - Phone:805-235-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
08060402541OtherNATA