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General NPI Number Information
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NPI Number | 1841379203
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Entity Type | Individual
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Provider Name | EILEEN HANSON BUTCHER PT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12657 ALCOSTA BLVD SUITE 130
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City | SAN RAMON
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State | CA
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Zip | 94583-4438
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Country | US
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Telephone | 925-275-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 9429 CALIFORNIA OAK CIRCLE
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City | PATTERSON
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State | CA
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Zip | 95363
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Country | US
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Telephone | 209-892-6485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT 5895
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License Number State | CA
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