Provider Demographics
NPI:1477857548
Name:PEBLEY, ADRIANA (MSPA)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:PEBLEY
Suffix:
Gender:F
Credentials:MSPA
Other - Prefix:MS
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:YANEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2238 N KEYSTONE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2707
Mailing Address - Country:US
Mailing Address - Phone:213-446-1998
Mailing Address - Fax:
Practice Address - Street 1:2238 N KEYSTONE ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2707
Practice Address - Country:US
Practice Address - Phone:213-446-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner