Provider Demographics
NPI:1356523971
Name:ADEN, PAMELA LYNNE (PT)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LYNNE
Last Name:ADEN
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 1:208 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1572
Mailing Address - Country:US
Mailing Address - Phone:415-924-7757
Mailing Address - Fax:
Practice Address - Street 1:208 REDWOOD AVE
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1572
Practice Address - Country:US
Practice Address - Phone:415-924-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic