Provider Demographics
NPI:1346269420
Name:WILLIAMS-LIJBERS, GRETTA MARGRIET (PT)
Entity Type:Individual
Prefix:MRS
First Name:GRETTA
Middle Name:MARGRIET
Last Name:WILLIAMS-LIJBERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:GRETTA
Other - Middle Name:MARGRIET
Other - Last Name:LIJBERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:100 WILSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7885
Mailing Address - Country:US
Mailing Address - Phone:831-242-8394
Mailing Address - Fax:
Practice Address - Street 1:611 ABBOTT ST STE 100
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4391
Practice Address - Country:US
Practice Address - Phone:831-755-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS84868Medicare UPIN
CA0PT175711Medicare ID - Type Unspecified