Healthcare Provider Details

I. General information

NPI: 1740198290
Provider Name (Legal Business Name): SEERAT KANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 BROADWAY FL 2
OAKLAND CA
94611-5613
US

IV. Provider business mailing address

13430 CANYONWOOD CT
MOORPARK CA
93021-3021
US

V. Phone/Fax

Practice location:
  • Phone: 805-823-5501
  • Fax:
Mailing address:
  • Phone: 805-823-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: