Provider Demographics
NPI:1265784748
Name:HOWARD, EILEEN (DPT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:HOWARD
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 1:45 SOUTHGATE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1413
Mailing Address - Country:US
Mailing Address - Phone:650-985-7588
Mailing Address - Fax:650-985-7589
Practice Address - Street 1:45 SOUTHGATE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1413
Practice Address - Country:US
Practice Address - Phone:650-985-7588
Practice Address - Fax:650-985-7589
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist