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General NPI Number Information
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NPI Number | 1548586332
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Entity Type | Individual
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Provider Name | AMY WAKABAYASHI BECKER DPT
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Gender | Female
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 4105 OCEAN VIEW BLVD SUITE A
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City | MONTROSE
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State | CA
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Zip | 91020-1520
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Country | US
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Telephone | 818-792-5143
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CONGRESS ST SUITE 303
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City | PASADENA
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State | CA
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Zip | 91105-3024
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Country | US
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Telephone | 858-414-6552
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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 | 36638
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License Number State | CA
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