Provider Demographics
NPI:1518376326
Name:LITTMAN, JEANNE BRADSHAW (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:BRADSHAW
Last Name:LITTMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:JEANNE
Other - Middle Name:LOU
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:P O BOX 424
Mailing Address - Street 2:
Mailing Address - City:LAKE HUGHES
Mailing Address - State:CA
Mailing Address - Zip Code:93532
Mailing Address - Country:US
Mailing Address - Phone:661-714-3393
Mailing Address - Fax:
Practice Address - Street 1:330 GOLDEN SHORE, SUITE 250
Practice Address - Street 2:SUPPLEMENTAL HEALTH CARE
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90250
Practice Address - Country:US
Practice Address - Phone:562-256-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist