Provider Demographics
NPI:1376841718
Name:HUKARI, ALEXA D (PT)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:D
Last Name:HUKARI
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 1:2270 DOUGLAS BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3869
Mailing Address - Country:US
Mailing Address - Phone:916-782-1212
Mailing Address - Fax:
Practice Address - Street 1:2267 LAS POSITAS RD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-8893
Practice Address - Country:US
Practice Address - Phone:916-782-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist