Mikaela A Blevins
Physical Therapist in Roseville, CA. Individual provider (NPI-1).
NPI number1104723170
StatusActive
Last updated in NPPESOct 22, 2026
Details
- NPI
- 1104723170
- Entity type
- Individual (NPI-1)
- Name
- Mikaela A Blevins
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 22, 2026
- Certification date
- Oct 22, 2026
- Last updated
- Oct 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | CA | Yes |
Practice location
2231 Douglas Blvd Ste 100Roseville, CA 95661-4264
Phone 916-782-7848
Mailing address
1524 Avanti DrRoseville, CA 95661-3252
Phone 916-662-5946
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