Healthcare Provider Details

I. General information

NPI: 1972086700
Provider Name (Legal Business Name): AUBREE WYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BEACH BLVD
ANAHEIM CA
92804-1810
US

IV. Provider business mailing address

1301 W PROVIDENCE AVE
ORANGE CA
92868-3808
US

V. Phone/Fax

Practice location:
  • Phone: 714-816-0540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number295935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: