Provider Demographics
NPI:1144285362
Name:MEKATA, DEANNA LINTAG (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LINTAG
Last Name:MEKATA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260S SUNNYVALE AVE 2
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6273
Mailing Address - Country:US
Mailing Address - Phone:408-329-9604
Mailing Address - Fax:408-262-1321
Practice Address - Street 1:260S SUNNYVALE AVE 2
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6273
Practice Address - Country:US
Practice Address - Phone:408-329-9604
Practice Address - Fax:408-262-1321
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232712251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPTAN 0PT232711Medicare PIN