Healthcare Provider Details

I. General information

NPI: 1346614963
Provider Name (Legal Business Name): LAFAYETTE PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CIVIC DR STE 100
PLEASANT HILL CA
94523-1946
US

IV. Provider business mailing address

380 CIVIC DR STE 100
PLEASANT HILL CA
94523-1946
US

V. Phone/Fax

Practice location:
  • Phone: 925-284-3840
  • Fax: 855-814-4495
Mailing address:
  • Phone: 925-284-3840
  • Fax: 855-814-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JILL HANAE RAMSEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 925-284-6150