Provider Demographics
NPI:1639472731
Name:DUPREE, EMILY MARIE (PT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 MEDAU PL
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2808
Mailing Address - Country:US
Mailing Address - Phone:510-339-2116
Mailing Address - Fax:510-339-0647
Practice Address - Street 1:6125 MEDAU PL
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2808
Practice Address - Country:US
Practice Address - Phone:510-339-2116
Practice Address - Fax:510-339-0647
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist