Provider Demographics
NPI:1275169609
Name:SALAVERIA, LORELEI-LUAN GARCIA (RPT)
Entity Type:Individual
Prefix:
First Name:LORELEI-LUAN
Middle Name:GARCIA
Last Name:SALAVERIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5382 CLAYTON RD APT N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3276
Mailing Address - Country:US
Mailing Address - Phone:925-262-7766
Mailing Address - Fax:
Practice Address - Street 1:5382 CLAYTON RD APT N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3276
Practice Address - Country:US
Practice Address - Phone:925-262-7766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist