Provider Demographics
NPI:1427570126
Name:DAKHANE, PRIYA (PT)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:DAKHANE
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 1:1800 HARRISON ST, 7TH FL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3429
Mailing Address - Country:US
Mailing Address - Phone:510-625-2856
Mailing Address - Fax:877-738-4262
Practice Address - Street 1:1100 MAIN ST STE 190
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3515
Practice Address - Country:US
Practice Address - Phone:530-662-2835
Practice Address - Fax:916-983-5906
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA293128OtherCA STATE LICENSE BOARD