Provider Demographics
NPI:1427483122
Name:ALVARENGA, JENNA ASHLIN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:ASHLIN
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:JENNA
Other - Middle Name:ASHLIN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:183 W 243TH PL
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745
Mailing Address - Country:US
Mailing Address - Phone:626-232-4460
Mailing Address - Fax:
Practice Address - Street 1:183 W 243TH PL
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745
Practice Address - Country:US
Practice Address - Phone:626-232-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist