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General NPI Number Information
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NPI Number | 1245149194
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Entity Type | Organization
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Legal Business Name | STAC PHYSICAL THERAPY FAMILY, INC.
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 3736 ATHERTON RD STE 100
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City | ROCKLIN
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State | CA
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Zip | 95765-3814
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Country | US
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Telephone | 916-782-7848
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Fax |
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Provider Business Mailing Address
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Address Line | 3736 ATHERTON RD STE 100
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City | ROCKLIN
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State | CA
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Zip | 95765-3814
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OR NATIV
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Credential | PT
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Telephone | 510-653-5151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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