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General NPI Number Information
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NPI Number | 1093954943
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Entity Type | Organization
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Legal Business Name | BERETTA PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 4822 GOLDEN FOOTHILL PKWY UNIT 9
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9829
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Country | US
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Telephone | 916-941-2440
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Fax | 916-941-2450
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Provider Business Mailing Address
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Address Line | 4822 GOLDEN FOOTHILL PKWY UNIT 9
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9829
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Country | US
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Telephone | 916-941-2440
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Fax | 916-941-2450
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL BERETTA
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Credential | PT
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Telephone | 916-941-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT26962
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License Number State | CA
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