Provider Demographics
NPI:1518008895
Name:HAYDEN-FRANTZ, LAURA DIANNA (PT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:DIANNA
Last Name:HAYDEN-FRANTZ
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 1:3878 W CARSON ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6707
Mailing Address - Country:US
Mailing Address - Phone:310-372-7929
Mailing Address - Fax:
Practice Address - Street 1:3878 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6707
Practice Address - Country:US
Practice Address - Phone:310-543-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT 25164OtherPHYSICAL THERAPY LICENSE