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General NPI Number Information
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NPI Number | 1578835138
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Entity Type | Individual
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Provider Name | ALEXANDRA NUGENT FRESQUEZ DPT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2012
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Last Update Date | 01/29/2012
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Provider Practice Location Address
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Address Line | 300 S HARBOR BLVD SUITE 710
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City | ANAHEIM
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State | CA
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Zip | 92805-3733
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Country | US
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Telephone | 800-561-5207
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 AMHERST AVE
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City | FULLERTON
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State | CA
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Zip | 92831-1502
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Country | US
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Telephone | 714-307-2543
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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 | 38487
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License Number State | CA
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