Healthcare Provider Details

I. General information

NPI: 1508373887
Provider Name (Legal Business Name): ALISON LINDSAY KOBAYASHI DPT, PT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 AIRWAY DR STE 135
SANTA ROSA CA
95403-1678
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-8962
  • Fax: 707-521-8963
Mailing address:
  • Phone: 707-521-8962
  • Fax: 707-521-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: