Healthcare Provider Details

I. General information

NPI: 1780476036
Provider Name (Legal Business Name): QUIET DOG ORTHOTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4369 ARDEN WAY
SACRAMENTO CA
95864-3102
US

IV. Provider business mailing address

2721 S COLLEGE AVE UNIT B5
FORT COLLINS CO
80525-2197
US

V. Phone/Fax

Practice location:
  • Phone: 916-694-7673
  • Fax:
Mailing address:
  • Phone: 916-694-7673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. LEIGH ANN ALBERT
Title or Position: OWNER
Credential: C PED
Phone: 916-694-7673