Provider Demographics
NPI:1578732244
Name:CHRISTENSEN, CARI JANE (DPT)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:JANE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-8123
Mailing Address - Country:US
Mailing Address - Phone:909-307-9121
Mailing Address - Fax:909-307-9161
Practice Address - Street 1:1189 W STATE ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8123
Practice Address - Country:US
Practice Address - Phone:909-307-9121
Practice Address - Fax:909-307-9161
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT331402251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02588ZMedicare PIN