Provider Demographics
NPI:1417178286
Name:ANDREWS, JOANNE MARIE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:MARIE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 STONEY CREEK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ACAMPO
Mailing Address - State:CA
Mailing Address - Zip Code:95220
Mailing Address - Country:US
Mailing Address - Phone:209-339-0417
Mailing Address - Fax:
Practice Address - Street 1:2233 GRAND CANAL BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210
Practice Address - Country:US
Practice Address - Phone:209-953-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 6908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist