Provider Demographics
NPI:1033378724
Name:FARRELL, MICHELLE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:M
Last Name:FARRELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:KASHIWABARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:17 HELMCREST STREET
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1924
Mailing Address - Country:US
Mailing Address - Phone:949-831-1717
Mailing Address - Fax:
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:SADDLEBACK MEDICAL GROUP, INC, SUITE 130
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-588-8700
Practice Address - Fax:949-465-8159
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist