Provider Demographics
NPI:1770001679
Name:STOEHR, TREVOR SCOTT MICHAEL (DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:SCOTT MICHAEL
Last Name:STOEHR
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 GRAY AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3652
Mailing Address - Country:US
Mailing Address - Phone:530-671-8378
Mailing Address - Fax:530-660-8451
Practice Address - Street 1:851 GRAY AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3652
Practice Address - Country:US
Practice Address - Phone:530-671-8378
Practice Address - Fax:530-660-8451
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT293470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist