Provider Demographics
NPI:1164253415
Name:ASCEND PHYSICAL THERAPY AND PILATES WELLNESS PC
Entity type:Organization
Organization Name:ASCEND PHYSICAL THERAPY AND PILATES WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NASRAH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:510-876-8976
Mailing Address - Street 1:3636 CASTRO VALLEY BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4460
Mailing Address - Country:US
Mailing Address - Phone:510-876-8976
Mailing Address - Fax:
Practice Address - Street 1:3636 CASTRO VALLEY BLVD STE 9
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4460
Practice Address - Country:US
Practice Address - Phone:510-876-8976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty