Misty Renae Black, PTA
Misty Renae Black, PTA is a Physical Therapy Assistant in Sebastopol, California. Licensed in California. Registered with an NPI since 2006.
- Licensed in
- CA
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- PTA — Physical Therapist Assistant
- Delivers treatment under a physical therapist's direction.
Practice location Address checks out
100 Pleasant Hill Ave NSebastopol, CA 95472-3104
Phone: (707) 829-3282
Fax: (707) 829-3287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X · Licence AT6901 (CA) |
|---|---|
| Physical Therapist | Taxonomy 225100000X · Licence AT6901 (CA) |
Record details
| NPI number | 1043386220 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PTA |
| Sole proprietor | No |
| NPI enumerated | November 28, 2006 |
| Last updated in NPPES | March 1, 2022 |
| Certification date | March 1, 2022 |
Other providers in Sebastopol
-
Mrs. Holly Ann Matticola, PTA
100 Pleasant Hill Ave N, Sebastopol, CA 95472-3104 · (707) 829-3282
-
Kyle Rudderow
100 Pleasant Hill Ave N, Sebastopol, CA 95472-3104 · (707) 829-3282