Provider Demographics
NPI:1457695215
Name:SATO, MAKIKO C (PT DPT)
Entity type:Individual
Prefix:
First Name:MAKIKO
Middle Name:C
Last Name:SATO
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 HUMBOLDT RD
Mailing Address - Street 2:72
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 SPRINGFIELD DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-6340
Practice Address - Country:US
Practice Address - Phone:530-342-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-18
Last Update Date:2012-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39243174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist