Provider Demographics
NPI:1841662343
Name:DABRESIL, NAYENDRA (PT)
Entity type:Individual
Prefix:
First Name:NAYENDRA
Middle Name:
Last Name:DABRESIL
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 1:4101 INNOVATOR DR
Mailing Address - Street 2:APT 1027
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3851
Mailing Address - Country:US
Mailing Address - Phone:321-947-9575
Mailing Address - Fax:
Practice Address - Street 1:7230 S LAND PARK DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3659
Practice Address - Country:US
Practice Address - Phone:916-393-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT43186225100000X
FLPT30631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist