Individual
MS. CAROLYN JOYCE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1440 168TH AVE, SAN LEANDRO, CA 94578-2409
(510) 481-8575
Mailing address
3317 WYMAN ST, OAKLAND, CA 94619-3454
(510) 682-6140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6243
CA
Other
Enumeration date
05/26/2007
Last updated
07/08/2007
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