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General NPI Number Information
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NPI Number | 1073350286
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Entity Type | Individual
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Provider Name | DANTE G FARINELLI PTA
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Gender | Male
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Dates
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Enumeration Date | 07/15/2024
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 3510 E SHIELDS AVE
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City | FRESNO
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State | CA
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Zip | 93726-6909
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Country | US
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Telephone | 559-222-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 5582 W WATHEN AVE
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City | FRESNO
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State | CA
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Zip | 93722-3023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 53047
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License Number State | CA
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