Basic Information
| Provider Information | |||||||||
| NPI: | 1821553686 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARAYA | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PTA, CLT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5989 OCEAN HILLS WAY | ||||||||
| Address2: | |||||||||
| City: | LIVERMORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945515667 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 JOHN MUIR PKWY STE 250 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945135194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253088160 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2019 | ||||||||
| LastUpdateDate: | 02/06/2019 | ||||||||
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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 | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.