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General NPI Number Information
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NPI Number | 1699928333
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 3505 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94611-5714
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Country | US
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Telephone | 510-752-1851
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Fax |
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Provider Business Mailing Address
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Address Line | 3505 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94611-5714
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Country | US
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Telephone | 510-752-1851
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/PEDIATRIC SP.
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Name | MS. SHARON TREPPA WHITE
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Credential | P.T.
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Telephone | 510-752-1851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | PT15860
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT15860
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License Number State | CA
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