Healthcare Provider Details

I. General information

NPI: 1942932900
Provider Name (Legal Business Name): CAITLIN RENEE SENNECA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 SANTIAGO ST
SAN FRANCISCO CA
94116-1526
US

IV. Provider business mailing address

438 25TH AVE APT 4
SAN FRANCISCO CA
94121-1941
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2222
  • Fax:
Mailing address:
  • Phone: 510-325-7949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number50091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: