Provider Demographics
NPI:1699378448
Name:GLADNEY, ERICA JANE
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JANE
Last Name:GLADNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 S PASADENA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4462
Mailing Address - Country:US
Mailing Address - Phone:559-801-2477
Mailing Address - Fax:
Practice Address - Street 1:634 S PASADENA AVE APT 2
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4462
Practice Address - Country:US
Practice Address - Phone:559-801-2477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist