Healthcare Provider Details

I. General information

NPI: 1316756406
Provider Name (Legal Business Name): HEALDSBURG PHYSICAL THERAPY AND WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 MARCH AVE STE B
HEALDSBURG CA
95448-3371
US

IV. Provider business mailing address

465 MARCH AVE STE B
HEALDSBURG CA
95448-3371
US

V. Phone/Fax

Practice location:
  • Phone: 707-433-5219
  • Fax:
Mailing address:
  • Phone: 707-433-5219
  • Fax: 707-433-5248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRINDA R BARCELON
Title or Position: OWNER
Credential: PT
Phone: 707-433-5219