Jennifer Andre, PT,DPT
Individual provider Active NPI Physical Therapist · Hawthorne, CA
NPI 1053734152 · NPPES record last updated May 15, 2018
Key facts
- NPI
- 1053734152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40844 (CA)
- Practice address
- 11840 S la Cienega Blvd
Hawthorne, CA 90250 - Phone
- (424) 226-9340
- Fax
- (310) 882-5451
- NPI assigned
- Jan 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40844 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40844 | CA | Yes |
Addresses
Primary practice location
11840 S la Cienega Blvd
Hawthorne, CA 90250
Mailing address
5220 W 104TH St
Los Angeles, CA 90045-6102
Phone (310) 846-4250
Other providers in Hawthorne, CA
- Blanca Estela Amaya
- Daisy Amezcua Barajas
- Ananias E. Ebilane, M.D., Inc
- Erik Knute Anderson
- Uyen Nguyen Andrade
- Elisha Andrews
- Angel Wings Recovery of South Bay
- Angels Care Nursing Services, Inc.
- Angels Healing Home Health Care Corp
- Another Chance Rehab
All providers in Hawthorne, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.