Amanda Lubetich, PTA

Individual provider Active NPI Physical Therapy Assistant · Simi Valley, CA

NPI 1457724395 · NPPES record last updated Oct 31, 2015

Key facts

NPI
1457724395
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
10449 (CA)
Practice address
4050 Helene St
Simi Valley, CA 93063-2817
Phone
(805) 587-8580
NPI assigned
Oct 31, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10449CAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10449 CA Yes

Addresses

Primary practice location

4050 Helene St
Simi Valley, CA 93063-2817

Mailing address

4050 Helene St
Simi Valley, CA 93063-2817
Phone (805) 587-8580

Other providers in Simi Valley, CA

All providers in Simi Valley, CA · Physical Therapy Assistant in California

Sources for this page

Verify at the official NPI Registry.