Healthcare Provider Details

I. General information

NPI: 1831181908
Provider Name (Legal Business Name): TONYA M GARES-MATNEY MPT CERTIFIED MDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONYA M GARES

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 02/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 CALLOWAY DR SUITE 400
BAKERSFIELD CA
93312-2621
US

IV. Provider business mailing address

1201 23RD ST
BAKERSFIELD CA
93301
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-9066
  • Fax: 661-589-4209
Mailing address:
  • Phone: 661-327-4357
  • Fax: 661-327-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: