Provider Demographics
NPI:1174852057
Name:ROBERTS, LIANNA M (PT)
Entity type:Individual
Prefix:
First Name:LIANNA
Middle Name:M
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16615 LARK AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7645
Mailing Address - Country:US
Mailing Address - Phone:408-358-1460
Mailing Address - Fax:408-358-1459
Practice Address - Street 1:16615 LARK AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-7645
Practice Address - Country:US
Practice Address - Phone:408-358-1460
Practice Address - Fax:408-358-1459
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2021-04-05
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Provider Licenses
StateLicense IDTaxonomies
CA350992251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics