Provider Demographics
NPI:1447550447
Name:SCHRAMM, TERESA LYNNE (PT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNNE
Last Name:SCHRAMM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 BRANDEE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-8607
Mailing Address - Country:US
Mailing Address - Phone:707-568-0670
Mailing Address - Fax:
Practice Address - Street 1:3550 ROUND BARN BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1796
Practice Address - Country:US
Practice Address - Phone:707-566-5269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist