Healthcare Provider Details

I. General information

NPI: 1265378095
Provider Name (Legal Business Name): CLARIZZAH JOVELLE ANCHETA MACATUGAL PT, DPT, PRPC, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 HONOLULU AVE
MONTROSE CA
91020-1822
US

IV. Provider business mailing address

2340 HONOLULU AVE
MONTROSE CA
91020-1822
US

V. Phone/Fax

Practice location:
  • Phone: 310-978-7846
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number300567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: