Provider Demographics
NPI:1679057673
Name:GAERLAN, MARICRIS (PT)
Entity Type:Individual
Prefix:
First Name:MARICRIS
Middle Name:
Last Name:GAERLAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 EL CAMINO REAL APT 2125
Mailing Address - Street 2:
Mailing Address - City:COLMA
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3180
Mailing Address - Country:US
Mailing Address - Phone:727-488-7440
Mailing Address - Fax:
Practice Address - Street 1:5767 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-4208
Practice Address - Country:US
Practice Address - Phone:415-584-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist