Provider Demographics
NPI:1538227780
Name:KARLSSON, HANS A (PT)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:A
Last Name:KARLSSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 DONAHUE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-5434
Mailing Address - Country:US
Mailing Address - Phone:602-361-9986
Mailing Address - Fax:707-541-6721
Practice Address - Street 1:808 DONAHUE ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5434
Practice Address - Country:US
Practice Address - Phone:602-361-9986
Practice Address - Fax:707-541-6721
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z72734Medicare ID - Type Unspecified