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NPI Code Detail

MEDICARE: MRS. DEFNE ZEYNEP PETERSON PT,DPT

MEDICARE: MRS. DEFNE ZEYNEP PETERSON PT,DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251N0400XNeurology Physical Therapist
2225100000XPhysical TherapistPT36261CA

General Provider Information

NPI Number : 1619380706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEFNE ZEYNEP PETERSON PT,DPT
Provider Business Mailing Address
First Line : PO BOX 255228
Second Line :
City : SACRAMENTO
State : CA
Zip : 95865-5228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 770 MASON ST
Second Line :
City : VACAVILLE
State : CA
Zip : 95688-4646
Country : US
Telephone Number : 707-454-5990
Fax Number : 707-454-5991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 12/05/2024

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