| Doctor Name: | SERENA DETIENNE RODA |
| NPI Number: | 1770511354 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT26281 |
| Business Practice Address: | 1345 Park St Paso Robles, CA - 934462236 |
| Business Phone Number: | 8052260975 |
| Business Fax Number: | 8052260909 |
| Mailing Address: | 1106 Walnut St # 110, SAN LUIS OBISPO |
| State: | CA |
| Postal Code: | 934012416 |
| Phone Number: | 8057880805 |
| Fax Number: | 8057880845 |
| NPI Enumeration Date: | 06/30/2006 |
| NPI Last Update Date: | 07/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT26281 |
| 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 |