Provider Demographics
NPI:1679290720
Name:TABAR, ARIELLE NICOLE MAGTIBAY (DPT)
Entity Type:Individual
Prefix:DR
First Name:ARIELLE NICOLE
Middle Name:MAGTIBAY
Last Name:TABAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 W ATHERTON DR APT 108
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-9526
Mailing Address - Country:US
Mailing Address - Phone:510-672-5891
Mailing Address - Fax:
Practice Address - Street 1:1222 W COLONY RD STE 130
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9482
Practice Address - Country:US
Practice Address - Phone:209-764-4352
Practice Address - Fax:209-622-4159
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist