Provider Demographics
NPI:1548084064
Name:MANN, JESSICA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MANN
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 1:5301 BEE JAY CT
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3800
Mailing Address - Country:US
Mailing Address - Phone:916-204-5978
Mailing Address - Fax:
Practice Address - Street 1:990 RILEY ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3064
Practice Address - Country:US
Practice Address - Phone:916-355-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist