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General NPI Number Information
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NPI Number | 1760104715
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Entity Type | Individual
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Provider Name | TALYA DANIELLE CISNEROS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 26302 LA PAZ RD STE 105
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5327
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Country | US
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Telephone | 949-206-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 21 PALAZZO
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-9106
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Country | US
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Telephone | 949-230-4993
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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