Provider Demographics
NPI:1447338561
Name:ADAMS, ERIN TIMOTHY (PT)
Entity type:Individual
Prefix:MR
First Name:ERIN
Middle Name:TIMOTHY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CORTEZ ST
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-2311
Mailing Address - Country:US
Mailing Address - Phone:831-476-4825
Mailing Address - Fax:
Practice Address - Street 1:15 PENNY LN
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-6010
Practice Address - Country:US
Practice Address - Phone:831-724-8235
Practice Address - Fax:831-724-9099
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP978ZMedicare PIN
CACP932Medicare PIN