Healthcare Provider Details

I. General information

NPI: 1033763966
Provider Name (Legal Business Name): HARRISON HOWARD MA PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 EMBARCADERO CTR LBBY LEVEL
SAN FRANCISCO CA
94111-4003
US

IV. Provider business mailing address

2033 HASTE ST APT 120
BERKELEY CA
94704-1953
US

V. Phone/Fax

Practice location:
  • Phone: 415-495-2225
  • Fax:
Mailing address:
  • Phone: 408-564-3581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: