Provider Demographics
NPI:1154497766
Name:STRONG, PAMELA TRESNON (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:TRESNON
Last Name:STRONG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11696 BLACK RD
Mailing Address - Street 2:
Mailing Address - City:SMARTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95977
Mailing Address - Country:US
Mailing Address - Phone:530-432-6689
Mailing Address - Fax:
Practice Address - Street 1:1139 CIRBY WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-784-3707
Practice Address - Fax:916-782-9758
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 23261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist