Provider Demographics
NPI:1053836601
Name:IMHOF, ANINA CHRISTINE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANINA
Middle Name:CHRISTINE
Last Name:IMHOF
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 WIKIUP DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-7756
Mailing Address - Country:US
Mailing Address - Phone:707-542-5400
Mailing Address - Fax:
Practice Address - Street 1:140 WIKIUP DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-7756
Practice Address - Country:US
Practice Address - Phone:707-542-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293354208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation