Provider Demographics
NPI:1346416732
Name:NABETA, YURIKO (DPT)
Entity Type:Individual
Prefix:
First Name:YURIKO
Middle Name:
Last Name:NABETA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 STRAND UNIT 102
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-1068
Mailing Address - Country:US
Mailing Address - Phone:310-994-9267
Mailing Address - Fax:
Practice Address - Street 1:2001 WILSHIRE BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5683
Practice Address - Country:US
Practice Address - Phone:310-829-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029889225100000X
CA3012572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist