Provider Demographics
NPI:1588715759
Name:NAKAO, HILARY M (PT)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:M
Last Name:NAKAO
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 1:3645 GRAND AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2039
Mailing Address - Country:US
Mailing Address - Phone:510-883-3534
Mailing Address - Fax:510-255-6890
Practice Address - Street 1:3645 GRAND AVE STE 203
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-2039
Practice Address - Country:US
Practice Address - Phone:510-883-3534
Practice Address - Fax:510-255-6890
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056674Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER