Provider Demographics
NPI:1942258348
Name:BARSAMIAN, JEANNA M (DPT, OCS, ATC, CSCS)
Entity Type:Individual
Prefix:MS
First Name:JEANNA
Middle Name:M
Last Name:BARSAMIAN
Suffix:
Gender:F
Credentials:DPT, OCS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3142
Mailing Address - Country:US
Mailing Address - Phone:818-249-4847
Mailing Address - Fax:
Practice Address - Street 1:4630 ROSEMONT AVE
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3142
Practice Address - Country:US
Practice Address - Phone:818-249-4847
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28663208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT28663AMedicare ID - Type UnspecifiedPHYSICAL THERAPY