Healthcare Provider Details

I. General information

NPI: 1578897815
Provider Name (Legal Business Name): JOAN MARLENE ARIETA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 OAK PARK BLVD
PLEASANT HILL CA
94523-4601
US

IV. Provider business mailing address

1923 OAK PARK BLVD
PLEASANT HILL CA
94523-4601
US

V. Phone/Fax

Practice location:
  • Phone: 925-930-0545
  • Fax: 925-930-0717
Mailing address:
  • Phone: 925-930-0545
  • Fax: 925-930-0717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 7431
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 33235
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT 8707
License Number StateCA

VIII. Authorized Official

Name: DR. JOAN MARLENE ARIETA
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 925-930-0545