Provider Demographics
NPI:1730846783
Name:ARAIZA, VIVIANNA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:VIVIANNA
Middle Name:MARIE
Last Name:ARAIZA
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 1:244 E NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-4525
Mailing Address - Country:US
Mailing Address - Phone:209-684-5732
Mailing Address - Fax:
Practice Address - Street 1:534 E PINE ST STE A
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5536
Practice Address - Country:US
Practice Address - Phone:209-463-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist