Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 32887 | CA |
N | 2251E1300X | Electrophysiology, Clinical | 32887 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 32887 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 32887 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 32887 | CA |
NPI | 1497996250 |
---|---|
Provider Name | Mrs. Crisheila Mangabat Rutherford |
First Address | Chatsworth, CA 91311-3024 |
Second Address | Chatsworth, CA 91311-3024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 28/03/2017 |