Provider Demographics
NPI:1720340284
Name:JENKINS, TERRI GENAI (MS, SPED, ADMIN)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:GENAI
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MS, SPED, ADMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 W POPPYFIELDS DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4361
Mailing Address - Country:US
Mailing Address - Phone:626-945-1922
Mailing Address - Fax:
Practice Address - Street 1:177 W POPPYFIELDS DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-4361
Practice Address - Country:US
Practice Address - Phone:626-945-1922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner