| NPI | 1194050625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACIELA PAGANO Chief Executive Office 510-388-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 24633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 24633) |
| 2251S0007X Physical Therapist, Sports (Licence: CA 24633) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA 24633) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: CA 10612) | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2019-08-15 |