Provider Demographics
NPI:1235146473
Name:CASNER-KAY, SUSAN (MS, PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:CASNER-KAY
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 SARATOGA AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4668
Mailing Address - Country:US
Mailing Address - Phone:408-973-7700
Mailing Address - Fax:408-973-1600
Practice Address - Street 1:12900 SARATOGA AVE STE A1
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4668
Practice Address - Country:US
Practice Address - Phone:408-973-7700
Practice Address - Fax:408-973-1600
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT104661Medicare PIN