Doctor Name: | DIANE WHITESIDE |
NPI Number: | 1558310615 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT 8701 |
Business Practice Address: | 350 Bollinger Canyon Ln Ste A San Ramon, CA - 945824592 |
Business Phone Number: | 9257356414 |
Business Fax Number: | 9257356450 |
Mailing Address: | Po Box 612260, SAN JOSE |
State: | CA |
Postal Code: | 951612260 |
Phone Number: | 8773252776 |
Fax Number: | 4089454011 |
NPI Enumeration Date: | 05/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 8701 |
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 |