Healthcare Provider Details

I. General information

NPI: 1568425759
Provider Name (Legal Business Name): LILLIAN CHILGREN ORTIZ-SWITZER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2006
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1973 N TRACY BLVD
TRACY CA
95376-2459
US

IV. Provider business mailing address

1973 N TRACY BLVD
TRACY CA
95376-2459
US

V. Phone/Fax

Practice location:
  • Phone: 209-833-9490
  • Fax: 209-833-9493
Mailing address:
  • Phone: 209-833-9490
  • Fax: 209-833-9493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP.T. 8356
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberP.T.8356
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP.T. 8356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: