Provider Demographics
NPI:1902871049
Name:JANICE TOMITA PT & ASSOCIATES
Entity Type:Organization
Organization Name:JANICE TOMITA PT & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOMITA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-381-0541
Mailing Address - Street 1:591 REDWOOD HWY
Mailing Address - Street 2:#5260
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941
Mailing Address - Country:US
Mailing Address - Phone:415-381-0541
Mailing Address - Fax:415-381-0591
Practice Address - Street 1:591 REDWOOD HWY
Practice Address - Street 2:#5260
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-6033
Practice Address - Country:US
Practice Address - Phone:415-381-0541
Practice Address - Fax:415-381-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00PT97250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT97250Medicare PIN