Individual
MISS ANNA THERESA BUSTAMANTE GOYENECHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2800 BENEDICT DR, SAN LEANDRO, CA 94577-6840
(510) 357-8300
Mailing address
1286 MATTOX RD APT 52, ASHLAND, CA 94541-1200
(510) 398-3407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA9770
CA
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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