Healthcare Provider Details

I. General information

NPI: 1487944690
Provider Name (Legal Business Name): SYNAPSE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2011
Last Update Date: 04/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 CAPITOLA RD SUITE 1
CAPITOLA CA
95010-3572
US

IV. Provider business mailing address

4401 CAPITOLA RD SUITE 1
CAPITOLA CA
95010-3572
US

V. Phone/Fax

Practice location:
  • Phone: 831-295-8231
  • Fax: 831-621-4701
Mailing address:
  • Phone: 831-295-8231
  • Fax: 831-621-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ADRIANA MESA
Title or Position: PT
Credential: PT
Phone: 831-713-7457