Provider Demographics
NPI:1407944572
Name:WOLFE, RONALD CAVA (PT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:CAVA
Last Name:WOLFE
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 1:3300 WEBSTER ST STE 703
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3122
Mailing Address - Country:US
Mailing Address - Phone:510-835-5633
Mailing Address - Fax:510-835-2200
Practice Address - Street 1:3300 WEBSTER ST STE 703
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3122
Practice Address - Country:US
Practice Address - Phone:510-835-5633
Practice Address - Fax:510-835-2200
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist