Reno Zachery Davenport, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50488 Issued in CA

Practice address

2488 De la Cruz Blvd
Santa Clara, CA 95050-2923

Phone

(408) 247-7278

NPI assigned

Dec 5, 2021

Sex

Male

Sole proprietor

No

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": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1619635828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 BIRD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951251617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 DE LA CRUZ BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950502923",
            "telephone_number": "408-247-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "RENO",
        "middle_name": "ZACHERY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheeja Das, MD
• Rachana Dassani
• Datura Hospice, Inc.
• Shekar Davarya, M.D.
• Sangeeta Dave, MD
• David Hoewisch, DC Chiropractic Professional Corporation
• Marissa David
• Paul David, MD
• Joetta Davis-Maier, MD
• Aimee Colette Davis, PT

• Physical Therapy Assistant in Santa Clara, CA
• Providers in Santa Clara, 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 Dec 5, 2021; 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.