Provider Demographics
NPI:1639108459
Name:SHEAFFER-EGAN, BECKY LOUISE (PT)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:LOUISE
Last Name:SHEAFFER-EGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7960 SOQUEL DRIVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3990
Mailing Address - Country:US
Mailing Address - Phone:831-768-9707
Mailing Address - Fax:831-661-0296
Practice Address - Street 1:50 PENNY LN
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3079
Practice Address - Country:US
Practice Address - Phone:831-768-9707
Practice Address - Fax:831-728-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT21556225100000X, 2251E1200X, 2251H1300X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT215561Medicare PIN