Provider Demographics
NPI:1508967787
Name:ARMEDILLA, MELISSA CORPUZ (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:CORPUZ
Last Name:ARMEDILLA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:GERONA
Other - Last Name:CORPUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 5486
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-5486
Mailing Address - Country:US
Mailing Address - Phone:818-550-0900
Mailing Address - Fax:
Practice Address - Street 1:6815 NOBLE AVE STE 105
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-781-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist