Provider Demographics
NPI:1417029745
Name:BECHTEL GREENBERG, TERRI (DPT, PT, OCS, MTC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:BECHTEL GREENBERG
Suffix:
Gender:F
Credentials:DPT, PT, OCS, MTC
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:BECHTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, OCS, MTC
Mailing Address - Street 1:13540 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3826
Mailing Address - Country:US
Mailing Address - Phone:818-990-0267
Mailing Address - Fax:818-990-0261
Practice Address - Street 1:13540 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3826
Practice Address - Country:US
Practice Address - Phone:818-990-0267
Practice Address - Fax:818-990-0261
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ60692ZOtherBLUE SHIELD ID
CAZZZ60692ZOtherBLUE SHIELD ID