Provider Demographics
NPI:1699797530
Name:NEATE, SHELLEY L (PHYSICAL THERAPY)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:L
Last Name:NEATE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 AUTO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3727
Mailing Address - Country:US
Mailing Address - Phone:831-722-9680
Mailing Address - Fax:831-724-9311
Practice Address - Street 1:579 AUTO CENTER DR
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3727
Practice Address - Country:US
Practice Address - Phone:831-722-9680
Practice Address - Fax:831-724-9311
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT118510Medicare PIN
CAP56648Medicare UPIN