Provider Demographics
NPI:1407914088
Name:WILBUR, ERIKA (MSPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:WILBUR
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 HALIE CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0448
Mailing Address - Country:US
Mailing Address - Phone:530-894-7137
Mailing Address - Fax:
Practice Address - Street 1:1046 MANGROVE AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3548
Practice Address - Country:US
Practice Address - Phone:530-892-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 28224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT282240Medicare ID - Type UnspecifiedPHYSICAL THERAPY PROVIDER