Provider Demographics
NPI:1306005889
Name:DARAWAY, MA ESTELA QUIAL (PT)
Entity Type:Individual
Prefix:MISS
First Name:MA ESTELA
Middle Name:QUIAL
Last Name:DARAWAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ESTELA
Other - Middle Name:QUIAL
Other - Last Name:DARAWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1220 S ELISEO DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2006
Mailing Address - Country:US
Mailing Address - Phone:415-461-0748
Mailing Address - Fax:
Practice Address - Street 1:1220 S ELISEO DR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2006
Practice Address - Country:US
Practice Address - Phone:415-461-0748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 32811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist