Provider Demographics
NPI:1972030435
Name:SCHWEDE, SHELBY LYNN (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:SCHWEDE
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 STONERIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2723
Mailing Address - Country:US
Mailing Address - Phone:925-847-8833
Mailing Address - Fax:925-847-8772
Practice Address - Street 1:5980 STONERIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2723
Practice Address - Country:US
Practice Address - Phone:925-847-8833
Practice Address - Fax:925-847-8772
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CA2952302251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist