Provider Demographics
NPI:1215541024
Name:BRESSETTE, ERL (PT)
Entity Type:Individual
Prefix:MR
First Name:ERL
Middle Name:
Last Name:BRESSETTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 COLUMBINE CT
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4561
Mailing Address - Country:US
Mailing Address - Phone:510-314-5510
Mailing Address - Fax:
Practice Address - Street 1:6759 SIERRA CT STE A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2657
Practice Address - Country:US
Practice Address - Phone:925-803-0530
Practice Address - Fax:925-803-2047
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist