Theresa Ann Shark, P.T.

Individual provider Active NPI Physical Therapist · Ripon, CA

NPI 1376979591 · NPPES record last updated Sep 19, 2013

Key facts

NPI
1376979591
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
28975 (CA)
Practice address
103 E Main St
Ripon, CA 95366-2416
Phone
(209) 599-7073
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Xcel Orthopaedic Physical Therapy Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28975 CA Yes

Addresses

Primary practice location

103 E Main St
Ripon, CA 95366-2416

Mailing address

476 Otis Dr
Ripon, CA 95366-3337
Phone (505) 274-0884

Other providers in Ripon, CA

All providers in Ripon, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.