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General NPI Number Information
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NPI Number | 1649493800
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Entity Type | Individual
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Provider Name | HENRY CRUZ PT
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 145 HODENCAMP RD SUITE #100
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5810
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Country | US
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Telephone | 805-449-3489
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Fax |
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Provider Business Mailing Address
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Address Line | 400 PASEO CAMARILLO APT 316
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City | CAMARILLO
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State | CA
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Zip | 93010-5983
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Country | US
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Telephone | 805-383-4050
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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 | 22061
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License Number State | CA
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