Healthcare Provider Details

I. General information

NPI: 1407297054
Provider Name (Legal Business Name): SANDRA MICHELLE OROZCO-ANDERSON RTC, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E CENTRAL AVE
MADERA CA
93638-3109
US

IV. Provider business mailing address

1176 E LEXINGTON AVE
FRESNO CA
93720-2223
US

V. Phone/Fax

Practice location:
  • Phone: 559-674-8670
  • Fax:
Mailing address:
  • Phone: 559-439-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number22440
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number2919-T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: