Provider Demographics
NPI:1871746446
Name:SUAREZ, ANNA CARISSA ARROYO (PT)
Entity type:Individual
Prefix:MISS
First Name:ANNA CARISSA
Middle Name:ARROYO
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:307 87TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1754
Mailing Address - Country:US
Mailing Address - Phone:650-550-0050
Mailing Address - Fax:650-550-0070
Practice Address - Street 1:307 87TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1754
Practice Address - Country:US
Practice Address - Phone:650-550-0050
Practice Address - Fax:650-550-0070
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA23953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29841ZMedicare Oscar/Certification