Provider Demographics
NPI:1790926723
Name:MATSUDA, RIKAKO (PT)
Entity Type:Individual
Prefix:
First Name:RIKAKO
Middle Name:
Last Name:MATSUDA
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 1:96 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3016
Mailing Address - Country:US
Mailing Address - Phone:530-668-1010
Mailing Address - Fax:530-668-9799
Practice Address - Street 1:96 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3016
Practice Address - Country:US
Practice Address - Phone:530-668-1010
Practice Address - Fax:530-668-9799
Is Sole Proprietor?:No
Enumeration Date:2009-03-21
Last Update Date:2009-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT273032251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics