Provider Demographics
NPI:1659696433
Name:JAMESON, BRIGITTE GASPARINI (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:GASPARINI
Last Name:JAMESON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MISS
Other - First Name:BRIGITTE
Other - Middle Name:DIANE
Other - Last Name:GASPARINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:8717 VENICE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3216
Mailing Address - Country:US
Mailing Address - Phone:310-337-7115
Mailing Address - Fax:310-216-6153
Practice Address - Street 1:6315 ARIZONA PL
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-1252
Practice Address - Country:US
Practice Address - Phone:310-337-7115
Practice Address - Fax:310-216-6153
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT137632251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics