Individual
CHARITO QUIJANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
6101 FAIR OAKS BLVD, CARMICHAEL, CA 95608-4818
(916) 296-0561
Mailing address
11773 DIONYSUS WAY, RANCHO CORDOVA, CA 95742-8041
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT30070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
CA
01
—
NONE
PT
—
Enumeration date
12/01/2019
Last updated
12/01/2019
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