Provider Demographics
NPI:1700987799
Name:GAYMON, BARI JOY (PT)
Entity Type:Individual
Prefix:MRS
First Name:BARI
Middle Name:JOY
Last Name:GAYMON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BARI
Other - Middle Name:
Other - Last Name:ROCHETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3097 SCHOONER DRIVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:916-941-7151
Mailing Address - Fax:916-941-7151
Practice Address - Street 1:1004 FOWLER WAY #9
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:530-626-4734
Practice Address - Fax:530-626-6551
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 18239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist