Provider Demographics
NPI:1548413693
Name:CARACUT, CARLOTA JOVEN (PT, DPT)
Entity Type:Individual
Prefix:MISS
First Name:CARLOTA
Middle Name:JOVEN
Last Name:CARACUT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 LEISURE TOWN RD APT 127
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9446
Mailing Address - Country:US
Mailing Address - Phone:707-392-8895
Mailing Address - Fax:
Practice Address - Street 1:6801 LEISURE TOWN RD APT 127
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9446
Practice Address - Country:US
Practice Address - Phone:707-392-8895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-01
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25294225100000X
FLFL10189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8825247200Medicaid
FLE2389OtherMEDICARE PART B