Provider Demographics
NPI:1134874910
Name:POKORA, JANA (DPT)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:POKORA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:
Other - Last Name:LEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 VIA PRESA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-9476
Mailing Address - Country:US
Mailing Address - Phone:317-403-6651
Mailing Address - Fax:
Practice Address - Street 1:32353 SAN JUAN CREEK RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4254
Practice Address - Country:US
Practice Address - Phone:317-403-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-19
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39646208100000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation