Provider Demographics
NPI:1760719025
Name:METZLER, JENNIFER M (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:METZLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:UYEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5255 EL CAMINO REAL STE C
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-3351
Mailing Address - Country:US
Mailing Address - Phone:805-237-0272
Mailing Address - Fax:
Practice Address - Street 1:5255 EL CAMINO REAL STE C
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3351
Practice Address - Country:US
Practice Address - Phone:805-237-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP802ZMedicare PIN