Jennifer Ault, M.S., D.P.T., D.O.

Primary specialty

Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X

License

20A12255 Issued in CA

Practice address

2850 Telegraph Ave Ste 120
Berkeley, CA 94705-1159

Phone

(510) 204-8150

Fax

(510) 649-1238

NPI assigned

Mar 23, 2007

Last updated

May 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jaultdo137325@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Therapy Innovations, Inc

  • Physical Therapist
  • El Cerrito, CA
  • NPI 1184669756
  NPD (past)
• Physical Therapy Innovations, Inc

  • Physical Therapist
  • Albany, CA
  • NPI 1215945696
  NPD (past)
• Physical Therapy Innovations, Inc.

  • Physical Therapist
  • Oakland, CA
  • NPI 1710021993
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1205953247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "510-204-8150",
            "fax_number": "510-649-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 TELEGRAPH AVE STE 120",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051159",
            "telephone_number": "510-204-8150",
            "fax_number": "510-649-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULT",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.S., D.P.T., D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A12255",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "20A12255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "20A12255",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lauren Attiyeh, MFT
• Marvin Au
• Rebecca Au, LCSW
• Sara Au, LPCC
• Robert Aude, MFT
• Clinton Avalos
• Sharon Joy Avesar
• Isabel Victoria Avila Saiter
• David Raymond Avila
• Ana G Aviles, ASW

• Pain Medicine (Psychiatry & Neurology) Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pain Medicine (Psychiatry & Neurology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.