Provider Demographics
NPI:1710207345
Name:NAVARRO, PAULINE ANN (PT)
Entity type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:ANN
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12374 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3237
Mailing Address - Country:US
Mailing Address - Phone:650-575-9603
Mailing Address - Fax:650-948-7106
Practice Address - Street 1:373 PINE LN
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1687
Practice Address - Country:US
Practice Address - Phone:650-575-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93122251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics