Basic Information
| Provider Information | |||||||||
| NPI: | 1073095576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLE | ||||||||
| FirstName: | RITA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PT, DPT, NCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3171 GARRITY WAY APT 637 | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 948065837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6073415043 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3600 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946115730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107521000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2018 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 294770 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.