Provider Demographics
NPI:1255308680
Name:PARMENTER, BETTY A (PT)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:A
Last Name:PARMENTER
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 1:1582 W SAN MARCOS BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4081
Mailing Address - Country:US
Mailing Address - Phone:760-203-8474
Mailing Address - Fax:760-780-1589
Practice Address - Street 1:1582 W SAN MARCOS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4081
Practice Address - Country:US
Practice Address - Phone:760-203-8474
Practice Address - Fax:760-780-1589
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT13534AMedicare UPIN