Provider Demographics
NPI:1962979880
Name:SAYON, MARIDES A (PHYSICAL THERAPIST A)
Entity type:Individual
Prefix:MRS
First Name:MARIDES
Middle Name:A
Last Name:SAYON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 CAMINO MEDIA APT 3
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2011
Mailing Address - Country:US
Mailing Address - Phone:843-798-7111
Mailing Address - Fax:
Practice Address - Street 1:8201 CAMINO MEDIA APT 3
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-2011
Practice Address - Country:US
Practice Address - Phone:843-798-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
CA49323225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant