Provider Demographics
NPI:1447763537
Name:CORREA, INEZ FRANCESCA VILLARICO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:INEZ FRANCESCA
Middle Name:VILLARICO
Last Name:CORREA
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 1:500 CAGNEY LN APT 106
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2622
Mailing Address - Country:US
Mailing Address - Phone:949-689-6656
Mailing Address - Fax:
Practice Address - Street 1:500 CAGNEY LN APT 106
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2622
Practice Address - Country:US
Practice Address - Phone:949-689-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-10
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4398225100000X
CAPT293759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist