Healthcare Provider Details

I. General information

NPI: 1366720724
Provider Name (Legal Business Name): ROSALIE YEAGER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 BATH ST
SANTA BARBARA CA
93105-4330
US

IV. Provider business mailing address

2324 BATH ST
SANTA BARBARA CA
93105-4330
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-3870
  • Fax:
Mailing address:
  • Phone: 805-682-3870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 37895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: