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General NPI Number Information
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NPI Number | 1669920203
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Entity Type | Individual
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Provider Name | ANAL A SHAH DPT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 220 CONCOURSE BLVD
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City | SANTA ROSA
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State | CA
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Zip | 95403-8210
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Country | US
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Telephone | 844-527-7369
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Fax | 844-847-4943
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Provider Business Mailing Address
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Address Line | 220 CONCOURSE BLVD
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City | SANTA ROSA
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State | CA
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Zip | 95403-8210
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Country | US
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Telephone | 844-527-7369
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Fax | 844-847-4943
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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 | 296581
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 296581
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 296581
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License Number State | CA
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