Provider Demographics
NPI:1306033170
Name:TERRAPIN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:TERRAPIN PHYSICAL THERAPY
Other - Org Name:RIPPLE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PAZZAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-372-3579
Mailing Address - Street 1:PO BOX 222342
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93922-2342
Mailing Address - Country:US
Mailing Address - Phone:831-372-3579
Mailing Address - Fax:831-372-3779
Practice Address - Street 1:5 HARRIS CT
Practice Address - Street 2:BUILDING T, SUITE 102
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5750
Practice Address - Country:US
Practice Address - Phone:831-372-3579
Practice Address - Fax:831-372-3779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23205225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA342060663OtherTAX ID
CA342060663OtherTAX ID