Provider Demographics
NPI:1962708198
Name:BARNETT, JENNIFER SUE (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:BARNETT
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 1:1525 BARTON DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3920
Mailing Address - Country:US
Mailing Address - Phone:408-739-7955
Mailing Address - Fax:
Practice Address - Street 1:1525 BARTON DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3920
Practice Address - Country:US
Practice Address - Phone:408-739-7955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-05
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 142792251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics