Provider Demographics
NPI:1871612457
Name:MICHAELS, BARBARA ANNE (RPT)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PORTSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4128
Mailing Address - Country:US
Mailing Address - Phone:707-449-4059
Mailing Address - Fax:
Practice Address - Street 1:600 NUT TREE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4669
Practice Address - Country:US
Practice Address - Phone:707-449-3484
Practice Address - Fax:707-449-1803
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0984225100000X
CA73412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic