Provider Demographics
NPI:1275200354
Name:CAMPAS, GABRIELLA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:
Last Name:CAMPAS
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 1:607 E MAGNOLIA BLVD APT E
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2639
Mailing Address - Country:US
Mailing Address - Phone:818-903-3539
Mailing Address - Fax:
Practice Address - Street 1:300 W HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3402
Practice Address - Country:US
Practice Address - Phone:818-903-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist