Healthcare Provider Details

I. General information

NPI: 1790649440
Provider Name (Legal Business Name): INSPIRING GROWTH PEDIATRIC PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25697 LOCHMOOR RD
VALENCIA CA
91355-2403
US

IV. Provider business mailing address

25697 LOCHMOOR RD
VALENCIA CA
91355-2403
US

V. Phone/Fax

Practice location:
  • Phone: 661-770-5565
  • Fax:
Mailing address:
  • Phone: 661-770-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOL SALOME GOHL
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 661-770-5565