Provider Demographics
NPI:1356634919
Name:GARCIA-COOK, ANGELA ELENA (PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ELENA
Last Name:GARCIA-COOK
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 1:465 MARCH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3371
Mailing Address - Country:US
Mailing Address - Phone:707-433-5219
Mailing Address - Fax:707-433-5248
Practice Address - Street 1:465 MARCH AVE
Practice Address - Street 2:STE B
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3371
Practice Address - Country:US
Practice Address - Phone:707-433-5219
Practice Address - Fax:707-433-5248
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist