=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588296479
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST CLIFF PHYSICAL THERAPY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2020
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 41ST AVE STE I
-----------------------------------------------------
City | CAPITOLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95010-3933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-712-3312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 214 GHARKEY ST
-----------------------------------------------------
City | SANTA CRUZ
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95060-6104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-712-3312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROCHELLE BRANNAN
-----------------------------------------------------
Credential | MPT CLT LANA
-----------------------------------------------------
Telephone | 408-712-3312
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------