Healthcare Provider Details

I. General information

NPI: 1356589816
Provider Name (Legal Business Name): HANDS ON REHAB & AQUATICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 DOVE ST. SUITE 242
NEWPORT BEACH CA
92660
US

IV. Provider business mailing address

7921 PROFESSIONAL CIRCLE
HUNTINGTON BEACH CA
92648
US

V. Phone/Fax

Practice location:
  • Phone: 949-222-6444
  • Fax: 949-222-6447
Mailing address:
  • Phone: 714-871-8751
  • Fax: 714-847-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT24399
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License NumberPT24399
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberPT24399
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT24399
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT24399
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24399
License Number StateCA

VIII. Authorized Official

Name: SUZANNE JUDD BORGQUIST
Title or Position: OWNER/MPT
Credential: MPT
Phone: 714-847-8751