Provider Demographics
NPI:1306933676
Name:SOJKA, DEBRA MAY (PT)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MAY
Last Name:SOJKA
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 1:1437 SARKESIAN DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-4406
Mailing Address - Country:US
Mailing Address - Phone:707-763-7086
Mailing Address - Fax:
Practice Address - Street 1:169 LYNCH CREEK WAY
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2344
Practice Address - Country:US
Practice Address - Phone:707-763-0115
Practice Address - Fax:707-763-2130
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT192990Medicare ID - Type Unspecified