Provider Demographics
NPI:1003036930
Name:BELTRAMO, VICKIE (PT)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:BELTRAMO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 BRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-3450
Mailing Address - Country:US
Mailing Address - Phone:530-841-6256
Mailing Address - Fax:530-842-0232
Practice Address - Street 1:1852 FORT JONES ROAD
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097
Practice Address - Country:US
Practice Address - Phone:530-841-6211
Practice Address - Fax:530-842-3037
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 13302225100000X
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist