Provider Demographics
NPI:1407172851
Name:ALFORD, MARILYN C (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:C
Last Name:ALFORD
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 1:2626 TULLER AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-1441
Mailing Address - Country:US
Mailing Address - Phone:510-237-2836
Mailing Address - Fax:
Practice Address - Street 1:4442 PIEDMONT AVE
Practice Address - Street 2:SUITE F
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4231
Practice Address - Country:US
Practice Address - Phone:510-388-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8404225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics