Provider Demographics
NPI:1902948029
Name:FARRAR, MONIKA (MPT)
Entity Type:Individual
Prefix:MS
First Name:MONIKA
Middle Name:
Last Name:FARRAR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 DEL GANADO RD
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2310
Mailing Address - Country:US
Mailing Address - Phone:415-479-2203
Mailing Address - Fax:415-446-4476
Practice Address - Street 1:850 DEL GANADO RD
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2310
Practice Address - Country:US
Practice Address - Phone:415-479-2203
Practice Address - Fax:415-446-4476
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist