Provider Demographics
NPI:1396236675
Name:GIARDINI, JENA KATHERINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:KATHERINE
Last Name:GIARDINI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-9721
Mailing Address - Country:US
Mailing Address - Phone:989-493-9024
Mailing Address - Fax:
Practice Address - Street 1:2365 NORTHSIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2710
Practice Address - Country:US
Practice Address - Phone:619-804-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018680225100000X
IDPT-6443225100000X
CA296619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist