Provider Demographics
NPI:1316150402
Name:COLE, JAN (MA, PT)
Entity type:Individual
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First Name:JAN
Middle Name:
Last Name:COLE
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Gender:F
Credentials:MA, PT
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Mailing Address - Street 1:748 SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 E EL CAMINO REAL
Practice Address - Street 2:SUITE 130
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2804
Practice Address - Country:US
Practice Address - Phone:650-964-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT 104502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic