Provider Demographics
NPI:1205947348
Name:BAJADA, TANIA FRANGIEN (PT)
Entity type:Individual
Prefix:MRS
First Name:TANIA
Middle Name:FRANGIEN
Last Name:BAJADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2255 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3343
Mailing Address - Country:US
Mailing Address - Phone:925-930-6680
Mailing Address - Fax:925-930-7867
Practice Address - Street 1:2255 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE E
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3343
Practice Address - Country:US
Practice Address - Phone:925-930-6680
Practice Address - Fax:925-930-7867
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT263940Medicare PIN