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NPI Code Detail

MEDICARE: MRS. CARRIE SUSAN HARABURDA M.S.P.T.

MEDICARE: MRS. CARRIE SUSAN HARABURDA M.S.P.T.
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
1225100000XPhysical TherapistPT24375CA

General Provider Information

NPI Number : 1881706810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE SUSAN HARABURDA M.S.P.T.
Provider Business Mailing Address
First Line : 3717 MT DIABLO BLVD STE 100
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3547
Country : US
Telephone Number : 925-284-5300
Fax Number : 925-284-5381
Provider Business Practice Location Address
First Line : 3717 MT. DIABLO BLVD
Second Line : SUITE 100
City : LAFAYETTE
State : CA
Zip : 94549-3547
Country : US
Telephone Number : 925-284-5300
Fax Number : 925-284-5381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/07/2025

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