Healthcare Provider Details
I. General information
NPI: 1063675437
Provider Name (Legal Business Name): ANNA LEMOS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2008
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
755 UNIVERSITY AVE
SACRAMENTO CA
95825-6708
US
IV. Provider business mailing address
2288 AUBURN BLVD STE 107
SACRAMENTO CA
95821-1619
US
V. Phone/Fax
- Phone: 916-927-1333
- Fax: 916-927-1586
- Phone: 916-858-0950
- Fax: 916-858-0972
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT34607 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: