Provider Demographics
NPI:1568850618
Name:FOLCIK, TAMILLE
Entity Type:Individual
Prefix:
First Name:TAMILLE
Middle Name:
Last Name:FOLCIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 JESSIE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-2608
Mailing Address - Country:US
Mailing Address - Phone:916-628-7727
Mailing Address - Fax:916-922-7784
Practice Address - Street 1:501 JESSIE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2608
Practice Address - Country:US
Practice Address - Phone:916-628-7727
Practice Address - Fax:916-922-7784
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5124225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant