Provider Demographics
NPI:1780924704
Name:WORKMAN, JESSICA MIEKE CLAUS (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MIEKE CLAUS
Last Name:WORKMAN
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 1:9891 IRVINE CENTER DR.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-232-1955
Mailing Address - Fax:949-668-7822
Practice Address - Street 1:9891 IRVINE CENTER DR.
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-232-1955
Practice Address - Fax:949-668-7822
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39927225100000X
CAPT39927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist