Provider Demographics
NPI:1558457325
Name:EATON, JAMES ERIC (MSPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ERIC
Last Name:EATON
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N SUNRISE AVE
Mailing Address - Street 2:STE 1003
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2924
Mailing Address - Country:US
Mailing Address - Phone:916-782-1217
Mailing Address - Fax:
Practice Address - Street 1:151 N SUNRISE AVE
Practice Address - Street 2:STE1003
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2924
Practice Address - Country:US
Practice Address - Phone:916-782-1217
Practice Address - Fax:916-218-7466
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT190031Medicare ID - Type Unspecified