Provider Demographics
NPI:1720209547
Name:LEGASPI, JOANNE BLANCO (RPT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:BLANCO
Last Name:LEGASPI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39427 COLCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4920
Mailing Address - Country:US
Mailing Address - Phone:818-919-6278
Mailing Address - Fax:661-951-2940
Practice Address - Street 1:44444 20TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2714
Practice Address - Country:US
Practice Address - Phone:661-951-0090
Practice Address - Fax:661-951-2940
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist