Provider Demographics
NPI:1124595921
Name:UYEMURA, VICTORIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:UYEMURA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4892 LINDSTROM AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-2445
Mailing Address - Country:US
Mailing Address - Phone:949-517-2988
Mailing Address - Fax:
Practice Address - Street 1:4892 LINDSTROM AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-2445
Practice Address - Country:US
Practice Address - Phone:949-517-2988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist