Healthcare Provider Details

I. General information

NPI: 1831020585
Provider Name (Legal Business Name): CHRISTOPHER GREGORY CERCONE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 STONERIDGE DR
PLEASANTON CA
94588-8310
US

IV. Provider business mailing address

155 MALAGA AVE
DAVENPORT FL
33837-1423
US

V. Phone/Fax

Practice location:
  • Phone: 925-526-7066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: