Provider Demographics
NPI:1043440597
Name:ZAVALA, DESIREE MARIA (DPT)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:MARIA
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:MARIA
Other - Last Name:STIBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11126 NATIONAL BLVD APT 6
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4084
Mailing Address - Country:US
Mailing Address - Phone:760-912-1339
Mailing Address - Fax:
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist