Healthcare Provider Details

I. General information

NPI: 1831034214
Provider Name (Legal Business Name): PROVERBS PHYSICAL THERAPY & PERFORMANCE, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21800 BARTON RD STE 101&109
GRAND TERRACE CA
92313-4438
US

IV. Provider business mailing address

17341 ORANGE WAY
FONTANA CA
92335-3932
US

V. Phone/Fax

Practice location:
  • Phone: 951-776-7524
  • Fax:
Mailing address:
  • Phone: 909-232-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRENDA J MARQUEZ
Title or Position: CEO
Credential: DPT
Phone: 909-232-2661