Provider Demographics
NPI:1093807612
Name:PFISTER, SERENA R (DPT)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:R
Last Name:PFISTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 FARMLAND DR
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-9310
Mailing Address - Country:US
Mailing Address - Phone:805-686-4061
Mailing Address - Fax:
Practice Address - Street 1:2921 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3309
Practice Address - Country:US
Practice Address - Phone:805-898-1907
Practice Address - Fax:805-687-8121
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT285902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT28590AMedicare ID - Type Unspecified