Provider Demographics
NPI:1689760324
Name:BROWNRIDGE, SUSAN DENISE (DPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DENISE
Last Name:BROWNRIDGE
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 1:43 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2521
Mailing Address - Country:US
Mailing Address - Phone:415-990-6223
Mailing Address - Fax:
Practice Address - Street 1:43 KENT AVE
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-2521
Practice Address - Country:US
Practice Address - Phone:415-990-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 24542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist