Provider Demographics
NPI:1821033325
Name:SCHRECKENGAUST, JENNIFER (DPT)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SCHRECKENGAUST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 GARDEN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2464
Mailing Address - Country:US
Mailing Address - Phone:760-632-6942
Mailing Address - Fax:760-632-6819
Practice Address - Street 1:780 GARDEN VIEW CT
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2464
Practice Address - Country:US
Practice Address - Phone:760-632-6942
Practice Address - Fax:760-632-6819
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT28840Medicare ID - Type Unspecified
WPT28840BMedicare ID - Type Unspecified
WPT28840AMedicare ID - Type Unspecified
WPT28840CMedicare ID - Type Unspecified