| Doctor Name: | THERESA ANN SHARK |
| NPI Number: | 1376979591 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 28975 |
| Business Practice Address: | 103 E Main St Ripon, CA - 953662416 |
| Business Phone Number: | 2095997073 |
| Business Fax Number: | |
| Mailing Address: | 476 Otis Dr, RIPON |
| State: | CA |
| Postal Code: | 953663337 |
| Phone Number: | 5052740884 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2013 |
| NPI Last Update Date: | 09/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 28975 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |