Provider Demographics
NPI:1366671653
Name:MESA, ADRIANA PATRICIA (DPT, MS, OCS)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:PATRICIA
Last Name:MESA
Suffix:
Gender:F
Credentials:DPT, MS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2816
Mailing Address - Country:US
Mailing Address - Phone:831-713-7457
Mailing Address - Fax:831-401-2340
Practice Address - Street 1:734 E LAKE AVE STE 21
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3571
Practice Address - Country:US
Practice Address - Phone:831-713-7457
Practice Address - Fax:831-401-2340
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist