Provider Demographics
NPI:1013218320
Name:INBAR-HANSEN, PAMELA RENEE (MSPT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENEE
Last Name:INBAR-HANSEN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1711
Mailing Address - Country:US
Mailing Address - Phone:510-845-5537
Mailing Address - Fax:510-845-5537
Practice Address - Street 1:1356 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-1711
Practice Address - Country:US
Practice Address - Phone:510-845-5537
Practice Address - Fax:510-845-5537
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT175072251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology