Provider Demographics
NPI:1699850974
Name:SCHALL, SANDRA (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SCHALL
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 1:110 LA CASA VIA
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3088
Mailing Address - Country:US
Mailing Address - Phone:925-935-4866
Mailing Address - Fax:925-935-8873
Practice Address - Street 1:110 LA CASA VIA
Practice Address - Street 2:SUITE 100
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3088
Practice Address - Country:US
Practice Address - Phone:925-935-4866
Practice Address - Fax:925-935-8873
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT151860OtherMEDICARE PIN
CA0PT151861OtherMEDICARE PPIN GROUP
CAQ18796Medicare UPIN
CA0PT151860OtherMEDICARE PIN