MEDICARE: GLORIA SOTO REYES 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	PT11877	CA

General Provider Information

NPI Number	:	1467634634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA SOTO REYES PT

Provider Business Mailing Address
First Line	:	3150 CROW CANYON PL STE 110
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1716
Country	:	US
Telephone Number	:	925-831-8559
Fax Number	:	925-831-8821

Provider Business Practice Location Address
First Line	:	822 HARTZ WAY
Second Line	:	#105
City	:	DANVILLE
State	:	CA
Zip	:	94526-3433
Country	:	US
Telephone Number	:	925-831-8559
Fax Number	:

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

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	03/10/2023

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Directions to “ GLORIA SOTO REYES PT” Practice Location

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