Provider Demographics
NPI:1811058357
Name:WATER-SCHMEDER, OMAY (PT)
Entity type:Individual
Prefix:
First Name:OMAY
Middle Name:
Last Name:WATER-SCHMEDER
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 1:401 BICENTENNIAL WAY
Mailing Address - Street 2:EAST BLDG., SUITE 190
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2149
Mailing Address - Country:US
Mailing Address - Phone:707-571-3515
Mailing Address - Fax:707-571-4718
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:EAST BLDG., SUITE 190
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-571-3515
Practice Address - Fax:707-571-4718
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist