Provider Demographics
NPI:1023278561
Name:VIGNAUD, RHODAN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:RHODAN
Middle Name:
Last Name:VIGNAUD
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:RHODA
Other - Middle Name:
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3559 ROUND BARN CIRCLE
Mailing Address - Street 2:KAISER PERMANENTE
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403
Mailing Address - Country:US
Mailing Address - Phone:707-571-3921
Mailing Address - Fax:
Practice Address - Street 1:3559 ROUND BARN CIRCLE
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-571-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist