Healthcare Provider Details

I. General information

NPI: 1891917837
Provider Name (Legal Business Name): TRANSITIONS A REHABILITATION GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 MONTEREY ST
GILROY CA
95020-6615
US

IV. Provider business mailing address

7101 MONTEREY ST
GILROY CA
95020-6615
US

V. Phone/Fax

Practice location:
  • Phone: 408-842-6868
  • Fax: 408-842-2276
Mailing address:
  • Phone: 408-842-6868
  • Fax: 408-842-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. MARYANN KATHERINE KANTMANN
Title or Position: OWNER DIRECTOR OF PHYSICAL THERAPY
Credential: P.T.
Phone: 408-842-6868