Provider Demographics
NPI:1326516824
Name:DEMATTIO, BRIDGET ANN (PT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANN
Last Name:DEMATTIO
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 1:3858 SEA LAVENDER CT
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-6312
Mailing Address - Country:US
Mailing Address - Phone:530-229-1635
Mailing Address - Fax:
Practice Address - Street 1:3858 SEA LAVENDER CT
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-6312
Practice Address - Country:US
Practice Address - Phone:530-229-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371242251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics