Provider Demographics
NPI:1891917837
Name:TRANSITIONS A REHABILITATION GROUP, INC
Entity Type:Organization
Organization Name:TRANSITIONS A REHABILITATION GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:KANTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:408-842-6868
Mailing Address - Street 1:7101 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-6615
Mailing Address - Country:US
Mailing Address - Phone:408-842-6868
Mailing Address - Fax:408-842-2276
Practice Address - Street 1:7101 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-6615
Practice Address - Country:US
Practice Address - Phone:408-842-6868
Practice Address - Fax:408-842-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TC0700X, 225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAREH04522FMedicaid
CAREH04522FMedicaid
CA054522Medicare ID - Type Unspecified