Basic Information
| Provider Information | |||||||||
| NPI: | 1265833800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCOY | ||||||||
| FirstName: | CARA | ||||||||
| MiddleName: | KATHRINE KOCH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2750 GATEWAY OAKS DR | ||||||||
| Address2: | STE 310 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958333658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168877398 | ||||||||
| FaxNumber: | 9168877332 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 UNIVERSITY AVE | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958256726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166490700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2014 | ||||||||
| LastUpdateDate: | 02/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 41662 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.