Healthcare Provider Details

I. General information

NPI: 1912836834
Provider Name (Legal Business Name): NELSON TUMANDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39141 CIVIC CENTER DR STE 120
FREMONT CA
94538-5831
US

IV. Provider business mailing address

48932 ROSEGARDEN CT
FREMONT CA
94539-8034
US

V. Phone/Fax

Practice location:
  • Phone: 510-794-9672
  • Fax:
Mailing address:
  • Phone: 510-304-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT6004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: