Provider Demographics
NPI:1376265918
Name:GASTINEAU, DELANIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DELANIE
Middle Name:
Last Name:GASTINEAU
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 1:10162 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-4907
Mailing Address - Country:US
Mailing Address - Phone:714-861-4440
Mailing Address - Fax:714-861-4450
Practice Address - Street 1:10162 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-4907
Practice Address - Country:US
Practice Address - Phone:714-861-4440
Practice Address - Fax:714-861-4450
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist