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General NPI Number Information
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NPI Number | 1659082030
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Entity Type | Individual
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Provider Name | CRISTHY GRACE TAGARDA OLEGARIO DPT
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Gender | Female
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 5203 LAKEWOOD BLVD STE B
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City | LAKEWOOD
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State | CA
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Zip | 90712-2438
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Country | US
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Telephone | 562-633-2273
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Fax | 562-633-1796
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Provider Business Mailing Address
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Address Line | 5203 LAKEWOOD BLVD STE B
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City | LAKEWOOD
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State | CA
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Zip | 90712-2438
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Country | US
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Telephone | 562-633-2273
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Fax | 562-633-1796
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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 | 045782
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29871
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 308326
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License Number State | CA
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