Provider Demographics
NPI:1962186403
Name:PINKNEY, JADAH (PT, DPT)
Entity type:Individual
Prefix:
First Name:JADAH
Middle Name:
Last Name:PINKNEY
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 1:6542 PEACEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-2300
Mailing Address - Country:US
Mailing Address - Phone:704-574-6865
Mailing Address - Fax:
Practice Address - Street 1:951 S WESTLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3100
Practice Address - Country:US
Practice Address - Phone:805-778-8824
Practice Address - Fax:805-778-8825
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist