Healthcare Provider Details

I. General information

NPI: 1770734568
Provider Name (Legal Business Name): THERA TOUCH PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 EDDINGTON ST
UPLAND CA
91786-3438
US

IV. Provider business mailing address

1100 EDDINGTON ST
UPLAND CA
91786-3438
US

V. Phone/Fax

Practice location:
  • Phone: 818-281-5906
  • Fax:
Mailing address:
  • Phone: 818-281-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27482
License Number StateCA

VIII. Authorized Official

Name: CECILIA GODOY
Title or Position: CEO
Credential: PT, DPT
Phone: 818-281-5906