MEDICARE: ANGELA NICOLE DAVINI DPT, PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT210002594	DC
2	225100000X	Physical Therapist	306633	CA

General Provider Information

NPI Number	:	1285469239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA NICOLE DAVINI DPT, PT

Provider Business Mailing Address
First Line	:	2 COMMODORE DR UNIT 380
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-1600
Country	:	US
Telephone Number	:	916-956-3245
Fax Number	:

Provider Business Practice Location Address
First Line	:	3508 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-2401
Country	:	US
Telephone Number	:	202-897-3890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	12/05/2025

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