Healthcare Provider Details

I. General information

NPI: 1750928677
Provider Name (Legal Business Name): LAUREN ROBERTORI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 SOLANO AVE STE C
ALBANY CA
94706-1767
US

IV. Provider business mailing address

1225 SOLANO AVE STE C
ALBANY CA
94706-1767
US

V. Phone/Fax

Practice location:
  • Phone: 415-742-9994
  • Fax: 707-596-7638
Mailing address:
  • Phone: 415-742-9994
  • Fax: 707-596-7638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT297052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: