Healthcare Provider Details

I. General information

NPI: 1316700149
Provider Name (Legal Business Name): EMILY BREWER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 E ONTARIO AVE STE 101
CORONA CA
92881-6663
US

IV. Provider business mailing address

714 STEELVILLE MILL RD
ATGLEN PA
19310-9703
US

V. Phone/Fax

Practice location:
  • Phone: 951-407-9233
  • Fax:
Mailing address:
  • Phone: 610-425-0471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT032005
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: