Healthcare Provider Details

I. General information

NPI: 1932816204
Provider Name (Legal Business Name): SHEILA PERKINS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 MCHENRY AVE STE 445
MODESTO CA
95350-4573
US

IV. Provider business mailing address

1524 MCHENRY AVE STE 445
MODESTO CA
95350-4573
US

V. Phone/Fax

Practice location:
  • Phone: 209-571-1693
  • Fax:
Mailing address:
  • Phone: 209-571-1693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number303075
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: