Provider Demographics
NPI:1053652685
Name:UY, VERNICE BIANCA D
Entity Type:Individual
Prefix:
First Name:VERNICE BIANCA
Middle Name:D
Last Name:UY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:D
Other - Last Name:UY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:7614 MERRIMACK PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8246
Mailing Address - Country:US
Mailing Address - Phone:951-640-8711
Mailing Address - Fax:
Practice Address - Street 1:7614 MERRIMACK PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8246
Practice Address - Country:US
Practice Address - Phone:951-640-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39875225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist