Healthcare Provider Details

I. General information

NPI: 1588856801
Provider Name (Legal Business Name): ELIZABETH HANSEN D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ARAND

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 W SAN MARCOS BLVD STE 102
SAN MARCOS CA
92078-1142
US

IV. Provider business mailing address

540 S ANDREASEN DR STE C
ESCONDIDO CA
92029-1916
US

V. Phone/Fax

Practice location:
  • Phone: 760-471-2440
  • Fax: 760-471-2442
Mailing address:
  • Phone: 760-591-7750
  • Fax: 760-294-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number34757
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 9685
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: