Healthcare Provider Details

I. General information

NPI: 1689475246
Provider Name (Legal Business Name): ISABEL GRACE CARDOSO FERREIRA PT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISABEL GRACE BURROWS PT DPT

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CENTURY PARK E
LOS ANGELES CA
90067-1907
US

IV. Provider business mailing address

2415 32ND ST
SANTA MONICA CA
90405-2029
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-7100
  • Fax:
Mailing address:
  • Phone: 619-446-9749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number39117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: