Provider Demographics
NPI:1023208188
Name:DRENNON, ANAHITA (PT)
Entity Type:Individual
Prefix:MS
First Name:ANAHITA
Middle Name:
Last Name:DRENNON
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 1:15066 LOS GATOS ALMADEN RD
Mailing Address - Street 2:STE 120
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3909
Mailing Address - Country:US
Mailing Address - Phone:408-355-0779
Mailing Address - Fax:408-377-2565
Practice Address - Street 1:15066 LOS GATOS ALMADEN RD
Practice Address - Street 2:STE 120
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3909
Practice Address - Country:US
Practice Address - Phone:408-335-0779
Practice Address - Fax:408-377-2565
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist