Provider Demographics
NPI:1063668309
Name:BEHRENS, PAULA MARIE
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:MARIE
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 JUNIPER ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-2735
Mailing Address - Country:US
Mailing Address - Phone:707-469-7022
Mailing Address - Fax:
Practice Address - Street 1:160 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-2735
Practice Address - Country:US
Practice Address - Phone:707-592-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist