Provider Demographics
NPI:1477725372
Name:SHEA, CLAUDIA LOUISE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:LOUISE
Last Name:SHEA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4345
Mailing Address - Country:US
Mailing Address - Phone:714-635-2642
Mailing Address - Fax:714-635-8547
Practice Address - Street 1:5722 BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-1422
Practice Address - Country:US
Practice Address - Phone:562-920-8394
Practice Address - Fax:562-867-6083
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist