Provider Demographics
NPI:1134105851
Name:HUGHEY, ANDREW GARRETT (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:GARRETT
Last Name:HUGHEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 FARMERS LN
Mailing Address - Street 2:SUTIE 10
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-6718
Mailing Address - Country:US
Mailing Address - Phone:707-571-7615
Mailing Address - Fax:707-571-8601
Practice Address - Street 1:795 FARMERS LN
Practice Address - Street 2:SUTIE 10
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-6718
Practice Address - Country:US
Practice Address - Phone:707-571-7615
Practice Address - Fax:707-571-8601
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT275252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT27525Medicare ID - Type UnspecifiedMEDICARE NUMBER