Cheryl Ann Bethke, P.T.

Individual provider Active NPI Physical Therapist · Placerville, CA

NPI 1669420352 · NPPES record last updated Oct 18, 2007

Key facts

NPI
1669420352
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT14686 (CA)
Practice address
1252 Broadway
Suite B
Placerville, CA 95667-5806
Phone
(530) 622-9410
Fax
(530) 622-9445
NPI assigned
May 4, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
14686CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fitzpatrick Physical Therapy Inc. Physical Therapist Past
since Jan 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14686 CA Yes

Addresses

Primary practice location

1252 Broadway
Suite B
Placerville, CA 95667-5806

Mailing address

1252 Broadway
Suite B
Placerville, CA 95667-5806
Phone (530) 622-9410

Other identifiers

IdentifierTypeStateIssuer
PT14686OtherCAPHYSICAL THERAPY LICENSE

Other providers in Placerville, CA

All providers in Placerville, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.