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General NPI Number Information
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NPI Number | 1427203140
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Entity Type | Individual
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Provider Name | JOANNA MAE CADIZ DE LA CRUZ PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 403 W ADAMS BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90007-2664
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Country | US
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Telephone | 213-742-1450
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Fax |
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Provider Business Mailing Address
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Address Line | 20136 E ARROW HWY
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City | COVINA
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State | CA
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Zip | 91724-1102
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Country | US
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Telephone | 347-479-2421
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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 | 030189
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 294717
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License Number State | CA
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