Provider Demographics
NPI:1053401182
Name:ENDRISS, SABINE (RPT)
Entity type:Individual
Prefix:MS
First Name:SABINE
Middle Name:
Last Name:ENDRISS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1533
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96160-1533
Mailing Address - Country:US
Mailing Address - Phone:530-582-0746
Mailing Address - Fax:
Practice Address - Street 1:11053 DONNER PASS RD
Practice Address - Street 2:TRUCKEE PHYSICAL THERAPY
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4839
Practice Address - Country:US
Practice Address - Phone:530-587-4790
Practice Address - Fax:530-587-4815
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT131000Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #