Provider Demographics
NPI:1801430459
Name:DARNEAL, BRIANNA (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:DARNEAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 TANK FARM RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7509
Mailing Address - Country:US
Mailing Address - Phone:805-439-3900
Mailing Address - Fax:805-439-3901
Practice Address - Street 1:211 TANK FARM RD STE A
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7509
Practice Address - Country:US
Practice Address - Phone:805-439-3900
Practice Address - Fax:805-439-3901
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist