| Doctor Name: | MS. CHERYL DENISE TIBBETTS |
| NPI Number: | 1306841267 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 19660 |
| Business Practice Address: | 4615 Scotts Valley Dr Suite D Scotts Valley, CA - 950664278 |
| Business Phone Number: | 8314384478 |
| Business Fax Number: | 8314385059 |
| Mailing Address: | 4615 Scotts Valley Dr, Suite D SCOTTS VALLEY |
| State: | CA |
| Postal Code: | 950664278 |
| Phone Number: | 8314384478 |
| Fax Number: | 8314385059 |
| NPI Enumeration Date: | 06/16/2005 |
| NPI Last Update Date: | 11/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 19660 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |