Jerilyn V Crisostomo-jaque, PT | |
612 W 11th St Ste 109, Tracy, CA 95376-3858 | |
(209) 834-2314 | |
(209) 834-2176 |
Full Name | Jerilyn V Crisostomo-jaque |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 612 W 11th St Ste 109, Tracy, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184710782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT29460 (California) | Primary |
Provider Name | Permanente Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Jerilyn V Crisostomo-jaque, PT 612 W 11th St Ste 109, Tracy, CA 95376-3858 Ph: (209) 834-2314 | Jerilyn V Crisostomo-jaque, PT 612 W 11th St Ste 109, Tracy, CA 95376-3858 Ph: (209) 834-2314 |
Amrita Patel, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1930 W Grant Line Rd, 1930 W Grant Line Road, Tracy, CA 95376 Phone: 209-833-9400 | |
Mrs. Kealoha Alyce Miller, PT, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1423 N Tracy Blvd, Tracy, CA 95376 Phone: 209-830-8855 Fax: 209-830-8837 | |
Mrs. Zoraida Lim Galvez, R.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1693 Saint Emillion Ct, Tracy, CA 95304 Phone: 209-830-0058 | |
Prime Home Physical Therapy P.c. Physical Therapist Medicare: Medicare Enrolled Practice Location: 1762 Schantz Way, Tracy, CA 95376 Phone: 510-410-7623 | |
Anna Lily Wong, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 855 S Tracy Blvd, Tracy, CA 95376 Phone: 209-803-9388 | |
Crystal Nerence Gomez Cunanan, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2586 Buthmann Ave, Tracy, CA 95376 Phone: 209-832-2273 |