Provider Demographics
NPI:1750442562
Name:STAUDUHAR, CHRISTINE MARY (PT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARY
Last Name:STAUDUHAR
Suffix:
Gender:F
Credentials:PT
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Other - First Name:
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Mailing Address - Street 1:1635 DIVISADERO ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3043
Mailing Address - Country:US
Mailing Address - Phone:415-833-4686
Mailing Address - Fax:415-833-2612
Practice Address - Street 1:1635 DIVISADERO ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3043
Practice Address - Country:US
Practice Address - Phone:415-833-4686
Practice Address - Fax:415-388-2612
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA182232251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic