Provider Demographics
NPI:1932982014
Name:CARPIO, MARICRIS DAAG
Entity Type:Individual
Prefix:
First Name:MARICRIS
Middle Name:DAAG
Last Name:CARPIO
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 1:2944 PARK PLACE CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-3830
Mailing Address - Country:US
Mailing Address - Phone:510-676-6773
Mailing Address - Fax:
Practice Address - Street 1:2944 PARK PLACE CMN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-3830
Practice Address - Country:US
Practice Address - Phone:510-676-6773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9179225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant