Provider Demographics
NPI:1093934432
Name:PARTHENON THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:PARTHENON THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOWGREN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:1310-833-8356
Mailing Address - Street 1:1840 S GAFFEY ST
Mailing Address - Street 2:SUITE 239
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-5324
Mailing Address - Country:US
Mailing Address - Phone:310-833-8356
Mailing Address - Fax:310-539-6146
Practice Address - Street 1:921 S BEACON ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3740
Practice Address - Country:US
Practice Address - Phone:131-083-3835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAW18747171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID