Provider Demographics
NPI:1639440357
Name:WOOLLEY, DALE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:
Last Name:WOOLLEY
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 1:3128 SANTA RITA RD STE B
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8330
Mailing Address - Country:US
Mailing Address - Phone:209-470-0528
Mailing Address - Fax:
Practice Address - Street 1:2600 STANWELL DR
Practice Address - Street 2:104
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4862
Practice Address - Country:US
Practice Address - Phone:925-686-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT38437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist