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General NPI Number Information
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NPI Number | 1386901940
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Entity Type | Individual
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Provider Name | BONNIE ELIZABETH BARRON PTA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 1571 N HARDING AVE
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City | PASADENA
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State | CA
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Zip | 91104-1940
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Country | US
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Telephone | 626-794-1224
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Fax | 626-794-1224
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Provider Business Mailing Address
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Address Line | PO BOX 264
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City | SIERRA MADRE
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State | CA
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Zip | 91025-0264
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT1834
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License Number State | CA
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