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Jennifer Lynn Line, PTA

Physical Therapy Assistant in Camarillo, CA. Individual provider (NPI-1).

NPI number1578020343
StatusActive
Last updated in NPPESFeb 27, 2019

Details

NPI
1578020343
Entity type
Individual (NPI-1)
Name
Jennifer Lynn Line
Credential
PTA
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 27, 2019
Last updated
Feb 27, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPT6515CAYes

Practice location

1269 Palmer Ave
Camarillo, CA 93010-3342

Phone 650-450-3809

Mailing address

1269 Palmer Ave
Camarillo, CA 93010-3342

Phone 650-450-3809

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