Individual
JACQLYN FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
800 S CLAREMONT ST, SUITE 106, SAN MATEO, CA 94402-1451
(650) 685-4800
Mailing address
800 S CLAREMONT ST, SUITE 106, SAN MATEO, CA 94402-1451
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40561
CA
Other
Enumeration date
10/16/2013
Last updated
08/09/2016
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