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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AGNES LEONIA VAN DE PUT, PT

Active Sole Proprietor

AGNES LEONIA VAN DE PUT, PT is a Physical Therapy Assistant healthcare provider located in SEBASTOPOL, California. NPI 1588812721 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · SEBASTOPOL, CA

Registration Details

NPI Number
1588812721
Provider Type
Individual
Gender
Female
NPI Issued
Aug 29, 2008 (17.933926616801 yrs)
Last Updated
Sep 6, 2023
Licenses
2160 (HI)
25323 (CA)
Sole Proprietor
Yes

Practice Information

Address
6914 SEBASTOPOL AVE
SEBASTOPOL, CA, 954723459
Browse CA providers · Browse ZIP 95472
Phone
7073270998
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in SEBASTOPOL, CA

Name Credential NPI
PAULA TANKSLEY PT 1093790529
PATRICIA DONOVAN MARTINEZ P.T. 1326180175
MRS. SAMANTHA MARIE JACOBS M.S.P.T. 1306988712
JORGEANNE SURGEE LABOU P.T. 1821285651
MS. GILLIAN M PENDLETON P.T 1639316631
OLIVIA KATHLEEN BARRY P.T. 1336473693
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.