Provider Demographics
NPI:1558948182
Name:NORCAL PHYSIOTHERAPY AND SPORTS SCIENCES
Entity Type:Organization
Organization Name:NORCAL PHYSIOTHERAPY AND SPORTS SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:408-439-1723
Mailing Address - Street 1:3747 W PACIFIC AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3747 W PACIFIC AVE STE C
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1000
Practice Address - Country:US
Practice Address - Phone:916-905-4541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-28
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy