Healthcare Provider Details

I. General information

NPI: 1629488655
Provider Name (Legal Business Name): ROSANNE O'LEARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6759 SIERRA CT SUITE A
DUBLIN CA
94568-2670
US

IV. Provider business mailing address

6759 SIERRA CT SUITE A
DUBLIN CA
94568-2670
US

V. Phone/Fax

Practice location:
  • Phone: 925-803-0530
  • Fax: 925-803-2047
Mailing address:
  • Phone: 925-803-0530
  • Fax: 925-803-2047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number41221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: