Provider Demographics
NPI:1437743762
Name:PACADA, AIMEE (PT, DPT, CCI)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:PACADA
Suffix:
Gender:F
Credentials:PT, DPT, CCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28501 FOOTHILL WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3290
Mailing Address - Country:US
Mailing Address - Phone:805-205-3654
Mailing Address - Fax:
Practice Address - Street 1:28501 FOOTHILL WAY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3290
Practice Address - Country:US
Practice Address - Phone:805-205-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist