Provider Demographics
NPI:1518121250
Name:NAJJAR, THERESA LIN (PT, NCS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LIN
Last Name:NAJJAR
Suffix:
Gender:F
Credentials:PT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E EL CAMINO REAL # 494
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3759
Mailing Address - Country:US
Mailing Address - Phone:408-724-8466
Mailing Address - Fax:
Practice Address - Street 1:1030 E EL CAMINO REAL # 494
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3759
Practice Address - Country:US
Practice Address - Phone:408-724-8466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35280225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist