Provider Demographics
NPI:1437692613
Name:EHRLICHMAN, DEVIN (DPT)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:EHRLICHMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3806
Mailing Address - Country:US
Mailing Address - Phone:559-860-9464
Mailing Address - Fax:
Practice Address - Street 1:4341 PIEDMONT AVE STE 201
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4792
Practice Address - Country:US
Practice Address - Phone:510-547-1630
Practice Address - Fax:510-923-1944
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
13975025OtherCAQH
CA292128OtherCALIFORNIA PHYSICAL THERAPY BOARD