=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184517427
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DARING GRAY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2025
-----------------------------------------------------
Last Update Date | 06/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15405 LOS GATOS BLVD STE 101
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-2500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-655-1433
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19300 SKYLINE BLVD
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95033-8261
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-201-9558
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | LEIGHANNA MURPHY
-----------------------------------------------------
Credential | NA
-----------------------------------------------------
Telephone | 650-201-9558
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------