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General NPI Number Information
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NPI Number | 1396110466
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Entity Type | Individual
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Provider Name | LAURA DAVALOS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 3443 STATE ST
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City | SANTA BARBARA
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State | CA
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Zip | 93105-2662
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Country | US
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Telephone | 805-682-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 18984 BARROSO ST
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3732
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Country | US
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Telephone | 626-715-6641
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 43285
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License Number State | CA
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