Healthcare Provider Details

I. General information

NPI: 1144250119
Provider Name (Legal Business Name): AMY SCHLIFTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11431 CA HWY 1, SUITE 9
POINT REYES STATION CA
94956
US

IV. Provider business mailing address

PO BOX 1228
POINT REYES STATION CA
94956-1228
US

V. Phone/Fax

Practice location:
  • Phone: 415-663-9216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT6870
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT13083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: