Provider Demographics
NPI:1437514452
Name:GEBHARDT, FELICE A (DPT)
Entity Type:Individual
Prefix:
First Name:FELICE
Middle Name:A
Last Name:GEBHARDT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:FELICE
Other - Middle Name:A
Other - Last Name:BARASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3070 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2310
Mailing Address - Country:US
Mailing Address - Phone:760-591-7750
Mailing Address - Fax:760-294-9813
Practice Address - Street 1:3070 MADISON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2310
Practice Address - Country:US
Practice Address - Phone:760-591-7750
Practice Address - Fax:760-294-9813
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT38267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGOtherMEDICARE PTAN