Provider Demographics
NPI:1396070660
Name:TAQUINO, CHRISTOPHER PATRICK (DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:TAQUINO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SEABRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2529
Mailing Address - Country:US
Mailing Address - Phone:831-425-3588
Mailing Address - Fax:831-425-3538
Practice Address - Street 1:1510 SEABRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2529
Practice Address - Country:US
Practice Address - Phone:831-425-3588
Practice Address - Fax:831-425-3538
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist