Provider Demographics
NPI:1104152503
Name:TRESS, DANIELLA (PT)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:TRESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:ROSS
Mailing Address - State:CA
Mailing Address - Zip Code:94957-0441
Mailing Address - Country:US
Mailing Address - Phone:415-737-5922
Mailing Address - Fax:
Practice Address - Street 1:32 ROSS CMN # 250
Practice Address - Street 2:
Practice Address - City:ROSS
Practice Address - State:CA
Practice Address - Zip Code:94957-9900
Practice Address - Country:US
Practice Address - Phone:415-737-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist