| NPI | 1679597215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET PHYLLIS LORD Practice Owner 510-549-2038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA G40776) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-09-06 |