Provider Demographics
NPI:1881706810
Name:HARABURDA, CARRIE SUSAN (MSPT)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:SUSAN
Last Name:HARABURDA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:SCHEBERIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3717 MT DIABLO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3547
Mailing Address - Country:US
Mailing Address - Phone:925-284-5300
Mailing Address - Fax:925-284-5381
Practice Address - Street 1:3717 MT. DIABLO BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3547
Practice Address - Country:US
Practice Address - Phone:925-284-5300
Practice Address - Fax:925-284-5381
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ17431ZMedicare PIN