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General NPI Number Information
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NPI Number | 1982825717
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Entity Type | Individual
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Provider Name | YVONNE MARIE FACHNER PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 805 TRAVIS ST
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City | FOLSOM
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State | CA
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Zip | 95630
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Country | US
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Telephone | 916-337-1203
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Fax | 916-985-3254
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Provider Business Mailing Address
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Address Line | 823 LANITA COURT
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City | ESCALON
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State | CA
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Zip | 95320-9578
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Country | US
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Telephone | 209-838-0245
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Fax | 209-838-6202
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT11314
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License Number State | CA
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