Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT41956 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT41956 | CA |
N | 2251N0400X | Physical Therapist - Neurology | PT41956 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT41956 | CA |
NPI | 1679961080 |
---|---|
Provider Name | Adriana Delgado |
First Address | Laguna Hills, CA 92653-3636 |
Second Address | Laguna Hills, CA 92653-3636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2015 |
Last Update Date | 07/01/2015 |