Provider Demographics
NPI:1780191718
Name:HARDY, CHRISTENSEN JAVIER (PT, DPT, MS)
Entity Type:Individual
Prefix:
First Name:CHRISTENSEN
Middle Name:JAVIER
Last Name:HARDY
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13186 CALLE DE LOS NINOS
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2919
Mailing Address - Country:US
Mailing Address - Phone:702-371-6231
Mailing Address - Fax:
Practice Address - Street 1:3532 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6510
Practice Address - Country:US
Practice Address - Phone:650-561-9895
Practice Address - Fax:650-561-9654
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist