Healthcare Provider Details

I. General information

NPI: 1124305313
Provider Name (Legal Business Name): THE BODY WITHIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 E LINDA MESA AVE SUITE 8
DANVILLE CA
94526-3339
US

IV. Provider business mailing address

199 E LINDA MESA AVE. SUITE 8
DANVILLE CA
94507
US

V. Phone/Fax

Practice location:
  • Phone: 925-820-6757
  • Fax:
Mailing address:
  • Phone: 925-820-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 16642
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberG23003
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberE1277
License Number StateCA

VIII. Authorized Official

Name: MRS. FRANCINE L SOKOLOFF
Title or Position: CHAIRMAN
Credential: MFT
Phone: 925-820-6757