Provider Demographics
NPI:1306403670
Name:BECKINGER, ADAM JOSEPH (MPT)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JOSEPH
Last Name:BECKINGER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 TRINITY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5275
Mailing Address - Country:US
Mailing Address - Phone:916-715-9957
Mailing Address - Fax:
Practice Address - Street 1:2076 TRINITY WAY
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-5275
Practice Address - Country:US
Practice Address - Phone:916-715-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist