Donna Louise Crikos, RPT

Individual provider Active NPI Physical Therapist · Fort Bragg, CA

NPI 1891799797 · NPPES record last updated Oct 22, 2007

Key facts

NPI
1891799797
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT11908 (CA)
Practice address
121 Boatyard Dr
Ste a
Fort Bragg, CA 95437-5751
Phone
(707) 964-1208
Fax
(707) 964-2269
NPI assigned
Jun 8, 2005
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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Physical Therapy Inc. Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11908 CA Yes

Addresses

Primary practice location

121 Boatyard Dr
Ste a
Fort Bragg, CA 95437-5751

Mailing address

PO Box 2740
Fort Bragg, CA 95437-2740
Phone (707) 964-6848

Other identifiers

IdentifierTypeStateIssuer
PT0119080MedicaidCA

Other providers in Fort Bragg, CA

All providers in Fort Bragg, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.