Healthcare Provider Details

I. General information

NPI: 1811801665
Provider Name (Legal Business Name): SHELBY ANN REALI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S OAK AVE
OAKDALE CA
95361-3519
US

IV. Provider business mailing address

268 TIMBERWOOD DR
OAKDALE CA
95361-8227
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-3011
  • Fax:
Mailing address:
  • Phone: 209-324-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number302660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: