Healthcare Provider Details

I. General information

NPI: 1295480002
Provider Name (Legal Business Name): ARIELL GROSS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 12/06/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WEBSTER ST STE 101
OAKLAND CA
94609-3106
US

IV. Provider business mailing address

2235 CALIFORNIA ST APT 3
BERKELEY CA
94703-1671
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax: 925-933-2709
Mailing address:
  • Phone: 415-342-6134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number301730
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number301730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: