Healthcare Provider Details

I. General information

NPI: 1902683741
Provider Name (Legal Business Name): HANNAH CARLEIGH BISHOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 W REDLANDS BLVD
REDLANDS CA
92373-4641
US

IV. Provider business mailing address

25432 LAWTON AVE
LOMA LINDA CA
92354-3692
US

V. Phone/Fax

Practice location:
  • Phone: 909-783-1111
  • Fax:
Mailing address:
  • Phone: 817-357-0916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019398
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: