Healthcare Provider Details

I. General information

NPI: 1649288648
Provider Name (Legal Business Name): CAPITOL PHYSICAL THERAPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 AUBURN BLVD STE 107
SACRAMENTO CA
95821-1619
US

IV. Provider business mailing address

2288 AUBURN BLVD STE 107
SACRAMENTO CA
95821-1619
US

V. Phone/Fax

Practice location:
  • Phone: 916-446-1497
  • Fax: 916-446-5959
Mailing address:
  • Phone: 916-446-1497
  • Fax: 916-446-5959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ALYSA KOREEN CAULFIELD
Title or Position: OWNER PHYSICAL THERAPIST
Credential: PT DPT
Phone: 916-446-1497