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General NPI Number Information
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NPI Number | 1457786907
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Entity Type | Individual
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Provider Name | VANESSA DAMIANI P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 145 HODENCAMP RD
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5810
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Country | US
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Telephone | 661-309-2499
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Fax |
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Provider Business Mailing Address
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Address Line | 2954 RIKKARD DR
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-4615
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Country | US
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Telephone | 805-449-3480
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 35085
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License Number State | CA
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