Provider Demographics
NPI:1639492127
Name:LANKES, JAMIE ANN-MARIE (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANN-MARIE
Last Name:LANKES
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 1:510 E NAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2519
Mailing Address - Country:US
Mailing Address - Phone:619-421-6083
Mailing Address - Fax:
Practice Address - Street 1:510 E NAPLES ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2519
Practice Address - Country:US
Practice Address - Phone:619-421-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36156225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist