Provider Demographics
NPI:1396826392
Name:CHACONAS, CECILE FLORENCE (PT)
Entity type:Individual
Prefix:
First Name:CECILE
Middle Name:FLORENCE
Last Name:CHACONAS
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 1:19 AUSTIN CT
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2820
Mailing Address - Country:US
Mailing Address - Phone:925-258-0707
Mailing Address - Fax:925-258-0717
Practice Address - Street 1:19 AUSTIN CT
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2820
Practice Address - Country:US
Practice Address - Phone:925-258-0707
Practice Address - Fax:925-258-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist