Provider Demographics
NPI:1851983688
Name:O'HARA, ABIGAIL ELLEN (DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELLEN
Last Name:O'HARA
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 1:234 FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-1030
Mailing Address - Country:US
Mailing Address - Phone:510-621-8461
Mailing Address - Fax:
Practice Address - Street 1:399 TAYLOR BLVD STE 208
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2287
Practice Address - Country:US
Practice Address - Phone:925-692-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist