Healthcare Provider Details

I. General information

NPI: 1144143728
Provider Name (Legal Business Name): ROOT & RISE PHYSIOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 MORRIS ST STE L
SEBASTOPOL CA
95472-3870
US

IV. Provider business mailing address

5150 WIKIUP BRIDGE WAY
SANTA ROSA CA
95404-1122
US

V. Phone/Fax

Practice location:
  • Phone: 707-217-9157
  • Fax: 888-308-0989
Mailing address:
  • Phone: 707-217-9157
  • Fax: 888-308-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA MARIE LEISEN
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 707-217-9157