Provider Demographics
NPI:1386376838
Name:FOLSOM, MICHELLE C (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:FOLSOM
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 1:3710 CAPRI DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2413
Mailing Address - Country:US
Mailing Address - Phone:916-834-2480
Mailing Address - Fax:
Practice Address - Street 1:3710 CAPRI DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-2413
Practice Address - Country:US
Practice Address - Phone:916-834-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist