Provider Demographics
NPI:1154422517
Name:MEYERHOF-JONES, LISA MARGOT (PT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARGOT
Last Name:MEYERHOF-JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29842 HIGHVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1518
Mailing Address - Country:US
Mailing Address - Phone:949-496-6505
Mailing Address - Fax:949-459-9020
Practice Address - Street 1:29803 SANTA MARGARITA PKWY
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3609
Practice Address - Country:US
Practice Address - Phone:949-459-9010
Practice Address - Fax:949-459-9020
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT11847AMedicare ID - Type Unspecified