Provider Demographics
NPI:1225391980
Name:GILBERT, REBECCA LINN (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LINN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 E WOODHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1414
Mailing Address - Country:US
Mailing Address - Phone:559-674-0915
Mailing Address - Fax:559-661-1228
Practice Address - Street 1:117 W DUNHAM ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5468
Practice Address - Country:US
Practice Address - Phone:559-674-0915
Practice Address - Fax:559-661-1228
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist