Provider Demographics
NPI:1609824945
Name:DILLON, BECKY M (PT)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:M
Last Name:DILLON
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 1:1306 W AVENUE J
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2936
Mailing Address - Country:US
Mailing Address - Phone:661-948-0186
Mailing Address - Fax:661-945-5736
Practice Address - Street 1:1306 W AVENUE J
Practice Address - Street 2:SUITE 2
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2936
Practice Address - Country:US
Practice Address - Phone:661-948-0186
Practice Address - Fax:661-945-5736
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 18499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist