Healthcare Provider Details

I. General information

NPI: 1285469239
Provider Name (Legal Business Name): ANGELA NICOLE DAVINI DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3508 CONNECTICUT AVE NW
WASHINGTON DC
20008-2401
US

IV. Provider business mailing address

2 COMMODORE DR UNIT 380
EMERYVILLE CA
94608-1600
US

V. Phone/Fax

Practice location:
  • Phone: 202-897-3890
  • Fax:
Mailing address:
  • Phone: 916-956-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT210002594
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number306633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: