Provider Demographics
NPI:1669712246
Name:JEMERA, JOSEPH (MPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:JEMERA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 955
Mailing Address - Street 2:
Mailing Address - City:RANCHO MURIETA
Mailing Address - State:CA
Mailing Address - Zip Code:95683-0955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7281 LONE PINE DR
Practice Address - Street 2:SUITE D103
Practice Address - City:RANCHO MURIETA
Practice Address - State:CA
Practice Address - Zip Code:95683-9715
Practice Address - Country:US
Practice Address - Phone:916-354-0719
Practice Address - Fax:916-354-1187
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist