Provider Demographics
NPI:1346710100
Name:STEFFEN, MARYSSA JEANNE (DPT)
Entity Type:Individual
Prefix:
First Name:MARYSSA
Middle Name:JEANNE
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 SUMMIT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3423
Mailing Address - Country:US
Mailing Address - Phone:510-788-1299
Mailing Address - Fax:510-217-3574
Practice Address - Street 1:2929 SUMMIT ST STE 208
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3423
Practice Address - Country:US
Practice Address - Phone:510-788-1299
Practice Address - Fax:510-217-3574
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist