Provider Demographics
NPI:1922167824
Name:PALMER, CAROLINE (PT)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:PALMER
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 1:514 VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2328
Mailing Address - Country:US
Mailing Address - Phone:415-596-6368
Mailing Address - Fax:
Practice Address - Street 1:1100 INDUSTRIAL RD STE 11B
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-4167
Practice Address - Country:US
Practice Address - Phone:650-503-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist