Healthcare Provider Details

I. General information

NPI: 1205818705
Provider Name (Legal Business Name): PEAK PERFORMANCE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ARCH STREET
REDWOOD CITY CA
94062
US

IV. Provider business mailing address

704 MOWRY AVE
FREMONT CA
94536
US

V. Phone/Fax

Practice location:
  • Phone: 650-839-0325
  • Fax: 510-790-3337
Mailing address:
  • Phone: 877-325-2776
  • Fax: 408-945-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANNE LASSON
Title or Position: VICE PRESIDENT
Credential: VP
Phone: 408-570-0510