Provider Demographics
NPI:1558551085
Name:LITTLEJOHN, JOCELYN TEN-EYCK (MPT)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:TEN-EYCK
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:TEN-EYCK
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:3560 J ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5445
Mailing Address - Country:US
Mailing Address - Phone:916-202-1980
Mailing Address - Fax:
Practice Address - Street 1:3560 J ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5445
Practice Address - Country:US
Practice Address - Phone:916-202-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist