Provider Demographics
NPI:1780075481
Name:MCCARTHY, EUGENIA ROSE (PT)
Entity type:Individual
Prefix:MRS
First Name:EUGENIA
Middle Name:ROSE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:EUGENIA
Other - Middle Name:ROSE
Other - Last Name:BERKOVITZ-MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3908 VALLEY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4872
Mailing Address - Country:US
Mailing Address - Phone:925-417-8005
Mailing Address - Fax:925-417-8881
Practice Address - Street 1:3908 VALLEY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4872
Practice Address - Country:US
Practice Address - Phone:925-417-8005
Practice Address - Fax:925-417-8881
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT42239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist