Provider Demographics
NPI:1982881959
Name:STARFISH PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:STARFISH PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:415-346-3853
Mailing Address - Street 1:1405 VAN NESS AVE
Mailing Address - Street 2:204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4645
Mailing Address - Country:US
Mailing Address - Phone:415-346-3853
Mailing Address - Fax:415-563-3545
Practice Address - Street 1:1405 VAN NESS AVE
Practice Address - Street 2:204
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4645
Practice Address - Country:US
Practice Address - Phone:415-346-3853
Practice Address - Fax:415-563-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA265332251P0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty