Provider Demographics
NPI:1316221658
Name:VALDEZ, GINA M (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:840 W VALLEY PKWY
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-2530
Mailing Address - Country:US
Mailing Address - Phone:760-741-7622
Mailing Address - Fax:760-741-7934
Practice Address - Street 1:840 W VALLEY PKWY
Practice Address - Street 2:SUITE # 250
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2530
Practice Address - Country:US
Practice Address - Phone:760-741-7622
Practice Address - Fax:760-741-7934
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT 38284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist