Provider Demographics
NPI:1053505230
Name:BELL, PATRICIA GRACE (PTA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GRACE
Last Name:BELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24552 PASEO DE VALENCIA
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4236
Mailing Address - Country:US
Mailing Address - Phone:949-609-7544
Mailing Address - Fax:949-609-7590
Practice Address - Street 1:24552 PASEO DE VALENCIA
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4236
Practice Address - Country:US
Practice Address - Phone:949-609-7544
Practice Address - Fax:949-609-7590
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT1683225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant