Healthcare Provider Details

I. General information

NPI: 1598386781
Provider Name (Legal Business Name): VICTORIA CONSANI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24422 AVENIDA DE LA CARLOTA STE 190
LAGUNA HILLS CA
92653-3634
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA STE 190
LAGUNA HILLS CA
92653-3634
US

V. Phone/Fax

Practice location:
  • Phone: 949-340-6927
  • Fax: 949-215-7246
Mailing address:
  • Phone: 949-340-6927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: