Healthcare Provider Details

I. General information

NPI: 1467439869
Provider Name (Legal Business Name): DIANA JUNE OSTERHUES D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 LAUREL CANYON BLVD STE 400
NORTH HOLLYWOOD CA
91606-1564
US

IV. Provider business mailing address

25756 OLIVAS PARK RD
VALENCIA CA
91355-2412
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-0136
  • Fax: 818-763-3838
Mailing address:
  • Phone: 661-254-1509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT7332
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: