Provider Demographics
NPI:1689182537
Name:D'ANGELO, JOANNA FRANCIS (PTA, CPT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:FRANCIS
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:PTA, CPT
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:FRANCIS
Other - Last Name:VILLAMOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2666 ASSOCIATED RD APT B55
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-5202
Mailing Address - Country:US
Mailing Address - Phone:310-494-1812
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3168
Practice Address - Country:US
Practice Address - Phone:562-698-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA487752251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics