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General NPI Number Information
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NPI Number | 1194279323
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Entity Type | Individual
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Provider Name | MRS. DEEPTI D YARLAGADDA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 2828 DAYLILY CT
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City | PLEASANTON
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State | CA
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Zip | 94588-2625
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Country | US
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Telephone | 650-743-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 SILVER OAKS LN
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City | PLEASANTON
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State | CA
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Zip | 94566-2285
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 36696
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License Number State | CA
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