Provider Demographics
NPI:1336659200
Name:SMALE, SIAN LEIGH (PT)
Entity Type:Individual
Prefix:
First Name:SIAN
Middle Name:LEIGH
Last Name:SMALE
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 1:47 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-5401
Mailing Address - Country:US
Mailing Address - Phone:415-799-3300
Mailing Address - Fax:415-799-3301
Practice Address - Street 1:1 EMBARCADERO CTR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3628
Practice Address - Country:US
Practice Address - Phone:415-799-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT293819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist