Provider Demographics
NPI:1003133661
Name:ALDEN THERAPY
Entity Type:Organization
Organization Name:ALDEN THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:559-381-9623
Mailing Address - Street 1:931 W INYOKERN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-2301
Mailing Address - Country:US
Mailing Address - Phone:559-381-9623
Mailing Address - Fax:760-446-3893
Practice Address - Street 1:931 W INYOKERN RD
Practice Address - Street 2:SUITE B
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-2301
Practice Address - Country:US
Practice Address - Phone:559-381-9623
Practice Address - Fax:760-446-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty