Healthcare Provider Details

I. General information

NPI: 1265665772
Provider Name (Legal Business Name): NORTH VALLEY PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11858 1/2 BALBOA BLVD
GRANADA HILLS CA
91344-2762
US

IV. Provider business mailing address

11858 1/2 BALBOA BLVD
GRANADA HILLS CA
91344-2762
US

V. Phone/Fax

Practice location:
  • Phone: 818-468-7068
  • Fax: 818-368-0455
Mailing address:
  • Phone: 818-468-7068
  • Fax: 818-368-0455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT13354
License Number StateCA

VIII. Authorized Official

Name: CARLA J KAZIMIR
Title or Position: PHYSICAL THERAPIST/ OWNER
Credential: PT
Phone: 818-468-7068