Shane Michael Bruno, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

49357 Issued in CA

Practice address

20211 Patio Dr Ste 205
Castro Valley, CA 94546-4338

Phone

(510) 537-3991

NPI assigned

Sep 7, 2018

Last updated

Sep 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1538642376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7574 STONEDALE DR",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20211 PATIO DR STE 205",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464338",
            "telephone_number": "510-537-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra A. Bronstein, MFT
• Jan Brooks, BSDH, RDH, RDHAP
• Brandon Brown, P.T.
• Bruce Ahtye DDS
• Helen Bruner, LCSW
• Preema Mehta Buch, MD
• Amer A. Budayr, MD
• Penna Kim Bui, M.D.
• Bullo LLC
• Narayana Venkata Bulusu, M.D.

• Physical Therapy Assistant in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.