Provider Demographics
NPI:1598108862
Name:STAUDT, LORETTA ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:ANN
Last Name:STAUDT
Suffix:
Gender:F
Credentials:PT
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UCLA ORTHO SURGERY 1000 VETERAN AVE
Mailing Address - Street 2:RM 22-64 REHABILATION BLDG
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-825-5858
Mailing Address - Fax:310-825-5290
Practice Address - Street 1:UCLA ORTHO SURGERY 1000 VETERAN AVE
Practice Address - Street 2:RM 22-64 REHABILATION BLDG
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-5858
Practice Address - Fax:310-825-5290
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT10973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist