Healthcare Provider Details

I. General information

NPI: 1487812244
Provider Name (Legal Business Name): BARBARA S MARCUM PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA S STRAUSS

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S WINCHESTER #5
SAN JOSE CA
95128
US

IV. Provider business mailing address

3097 STELLING CT
PALO ALTO CA
94303-3957
US

V. Phone/Fax

Practice location:
  • Phone: 408-241-7033
  • Fax:
Mailing address:
  • Phone: 650-856-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number10663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: