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General NPI Number Information
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NPI Number | 1750725891
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Entity Type | Individual
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Provider Name | MARIA DEL CARMEN TRAYLOR D.P.T
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Gender | Female
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | 32170 NIGUEL RD
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-4264
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Country | US
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Telephone | 650-793-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 22552 PETRA
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1125
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Country | US
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Telephone | 650-793-0136
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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 | PT 40065
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License Number State | CA
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