Provider Demographics
NPI:1952191413
Name:PELLETTIERI, GIANNA MICOL (DPT)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:MICOL
Last Name:PELLETTIERI
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 1:1046 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-7015
Mailing Address - Country:US
Mailing Address - Phone:510-205-8603
Mailing Address - Fax:
Practice Address - Street 1:1046 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-7015
Practice Address - Country:US
Practice Address - Phone:510-205-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy