Provider Demographics
NPI:1457455826
Name:THOMAS, BARBARA ANN (MPT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:HORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:25125 CLINTON KEITH RD
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-7708
Mailing Address - Country:US
Mailing Address - Phone:951-218-6787
Mailing Address - Fax:951-813-3899
Practice Address - Street 1:25125 CLINTON KEITH RD
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7708
Practice Address - Country:US
Practice Address - Phone:951-218-6787
Practice Address - Fax:951-813-3899
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005176225100000X
NE1414225100000X
PAPT 009439-L225100000X
CAPT 207582251X0800X
MSPT1623225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1414OtherSTATE LICENSE
CAPT20758OtherSTATE LICENSE
PAPT009439LOtherSTATE LICENSE
MSPT1623OtherSTATE LICENSE
CT005176OtherSTATE LICENSE
CAPT20758OtherSTATE LICENSE