Elizabeth Aguayo, PTA

Individual provider Active NPI Physical Therapy Assistant · Redlands, CA

NPI 1982122321 · NPPES record last updated Sep 6, 2017

Key facts

NPI
1982122321
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5397 (CA)
Practice address
10431 Commerce St Ste a
Redlands, CA 92374-0110
Phone
(909) 735-7654
NPI assigned
Sep 6, 2017
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
5397CAMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5397 CA Yes

Addresses

Primary practice location

10431 Commerce St Ste a
Redlands, CA 92374-0110

Mailing address

PO Box 1822
Redlands, CA 92373-0581
Phone (909) 735-7654

Other providers in Redlands, CA

All providers in Redlands, CA · Physical Therapy Assistant in California

Sources for this page

Verify at the official NPI Registry.