Provider Demographics
NPI:1487060943
Name:CARTER, ATALINA (ATC)
Entity type:Individual
Prefix:
First Name:ATALINA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 N 9TH ST
Mailing Address - Street 2:APT 204
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7462
Mailing Address - Country:US
Mailing Address - Phone:510-544-9876
Mailing Address - Fax:
Practice Address - Street 1:5133 N 9TH ST
Practice Address - Street 2:APT 204
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7462
Practice Address - Country:US
Practice Address - Phone:510-544-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer