Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT16992 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT16992 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT16992 | CA |
NPI | 1255516753 |
---|---|
Provider Name | Pamela L Monnahan |
First Address | Ladera Ranch, CA 92694-1152 |
Second Address | Ladera Ranch, CA 92694-1152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 16/01/2020 |