Provider Demographics
NPI:1972732782
Name:ANDINO, MARIA EMMA (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:EMMA
Last Name:ANDINO
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 1:2945 BELL ROAD,
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:916-765-1737
Mailing Address - Fax:530-888-0885
Practice Address - Street 1:2945 BELL ROAD,
Practice Address - Street 2:SUITE 215
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:916-765-1737
Practice Address - Fax:530-888-0885
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist