Provider Demographics
NPI:1225709199
Name:MAY, CASSANDRA (DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3118
Mailing Address - Country:US
Mailing Address - Phone:415-895-1705
Mailing Address - Fax:
Practice Address - Street 1:460 BOULEVARD WAY STE 2D
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:CA
Practice Address - Zip Code:94610-1563
Practice Address - Country:US
Practice Address - Phone:510-922-8872
Practice Address - Fax:510-291-2820
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist