Basic Information
| Provider Information | |||||||||
| NPI: | 1437551629 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIAGINI | ||||||||
| FirstName: | MARY | ||||||||
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| Credential: | P.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5812 ROSS ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946181630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5102055224 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14766 WASHINGTON AVE | ||||||||
| Address2: | WASHINGTON CENTER | ||||||||
| City: | SAN LEANDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945784220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103522211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2014 | ||||||||
| LastUpdateDate: | 09/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | AT 1921 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.