Provider Demographics
NPI:1679818108
Name:METCALF, JADE ELYSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:ELYSE
Last Name:METCALF
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3772 MISSION AVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1453
Mailing Address - Country:US
Mailing Address - Phone:760-630-8400
Mailing Address - Fax:
Practice Address - Street 1:9430 RESEARCH BLVD STE 2-350
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-6586
Practice Address - Country:US
Practice Address - Phone:512-710-6516
Practice Address - Fax:512-355-1966
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396182251X0800X
TX13299132251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic