Provider Demographics
NPI:1518973551
Name:FLORES, YVETTE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:FLORES
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:PO BOX 3524
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90408-3524
Mailing Address - Country:US
Mailing Address - Phone:800-507-2634
Mailing Address - Fax:310-774-3652
Practice Address - Street 1:2222 PICO BLVD #102
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405
Practice Address - Country:US
Practice Address - Phone:800-507-2634
Practice Address - Fax:310-774-3652
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist