Provider Demographics
NPI:1841343142
Name:YAMASHITA, PAMELA
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:YAMASHITA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 CASS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4548
Mailing Address - Country:US
Mailing Address - Phone:831-375-1135
Mailing Address - Fax:
Practice Address - Street 1:980 CASS ST
Practice Address - Street 2:SUITE A
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4548
Practice Address - Country:US
Practice Address - Phone:831-375-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT18796OtherBLUE SHIELD
CAPT18796OtherBLUE SHIELD