Agnes Leonia Van de Put, PT
Agnes Leonia Van de Put, PT is a Physical Therapist in Private Practice in Sebastopol, California. Qualified in 2018, 8 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California and Hawaii.
- Years since qualifying
- 8
- Licensed in
- CA, HI
- In the registry since
- 2008
- Specialties on file
- 2
What do these letters mean?
- PT — Physical Therapist
- A licensed therapist who treats movement, pain and injury.
Practice location Address checks out
6914 Sebastopol AveSebastopol, CA 95472-3459
Phone: (707) 327-0998
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapist (primary) | Taxonomy 225100000X · Licence 25323 (CA) |
|---|---|
| Physical Therapist | Taxonomy 225100000X · Licence 2160 (HI) |
Record details
| NPI number | 1588812721 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PT |
| Sole proprietor | Yes |
| NPI enumerated | August 29, 2008 |
| Last updated in NPPES | September 6, 2023 |
| Certification date | September 6, 2023 |
| Mailing address | 7809 Stefenoni Ct Unit A, Sebastopol, CA 95472-3536 |
Medicare enrollment
| Medicare specialty | PHYSICAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Sebastopol
-
MS. Natalie R Propach, DPT
501 Petaluma Ave, Sebastopol, CA 95472-4215 · (707) 823-8511
-
Andrew Russell, PT
8180 Stich Ln, Sebastopol, CA 95472-3153 · (510) 590-8417
-
Sebastopol Physical Therapy and Pilates Studio
100 Pleasant Hill Ave N, Sebastopol, CA 95472-3104 · (707) 829-3282
-
Paula Tanksley, PT
130 Petaluma Ave Ste 2-G, Sebastopol, CA 95472-4220 · (707) 888-5093