Provider Demographics
NPI:1356417471
Name:FARBER-DE ZUBIRIA, ANDREA LYNN (PT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:FARBER-DE ZUBIRIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:DE ZUBIRIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4860 N TEILMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-0563
Mailing Address - Country:US
Mailing Address - Phone:559-222-8262
Mailing Address - Fax:
Practice Address - Street 1:2071 HERNDON AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6101
Practice Address - Country:US
Practice Address - Phone:559-324-5578
Practice Address - Fax:559-324-5573
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist