Provider Demographics
NPI:1407046667
Name:CUNHA, JAMIE M (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:M
Last Name:CUNHA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BON AIR RD
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1123
Mailing Address - Country:US
Mailing Address - Phone:415-258-9894
Mailing Address - Fax:415-258-8105
Practice Address - Street 1:18 BON AIR RD
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1123
Practice Address - Country:US
Practice Address - Phone:415-258-9894
Practice Address - Fax:415-258-8105
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist