=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528039690
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET PETARRA PERRINO PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2006
-----------------------------------------------------
Last Update Date | 03/20/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 FREMONT AVE STE 108
-----------------------------------------------------
City | LOS ALTOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94024-6093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-947-8500
-----------------------------------------------------
Fax | 650-947-8501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1000 FREMONT AVE STE 108
-----------------------------------------------------
City | LOS ALTOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94024-6093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-947-8500
-----------------------------------------------------
Fax | 650-947-8501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT27306
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------