Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT33116 | CA |
NPI | 1104206770 |
---|---|
Provider Name | Ayn Marie Saniel-Asenjo |
First Address | Clovis, CA 93619-5098 |
Second Address | Clovis, CA 93619-5098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 11/02/2022 |