Provider Demographics
NPI:1003400664
Name:SHIBA, JOY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:SHIBA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15535 OAK SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2427
Mailing Address - Country:US
Mailing Address - Phone:909-576-2089
Mailing Address - Fax:
Practice Address - Street 1:17050 ARNOLD DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-2806
Practice Address - Country:US
Practice Address - Phone:833-399-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist