Provider Demographics
NPI:1902963697
Name:SENDAR, MARSHA ELLEN (MSPT)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:ELLEN
Last Name:SENDAR
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11 GREENLEAF LN
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-4004
Mailing Address - Country:US
Mailing Address - Phone:707-570-2090
Mailing Address - Fax:707-794-0285
Practice Address - Street 1:1410 GUERNEVILLE RD STE 19
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-4172
Practice Address - Country:US
Practice Address - Phone:707-570-2090
Practice Address - Fax:707-794-0285
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT192960Medicare UPIN