Provider Demographics
NPI:1851999767
Name:PHILLEO, ERIN L (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:L
Last Name:PHILLEO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MUNROE ST APT 16
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6422
Mailing Address - Country:US
Mailing Address - Phone:916-897-4994
Mailing Address - Fax:
Practice Address - Street 1:4300 GOLDEN CENTER DR
Practice Address - Street 2:SUITE B
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6278
Practice Address - Country:US
Practice Address - Phone:530-344-2045
Practice Address - Fax:530-642-0794
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist