Provider Demographics
NPI:1770854614
Name:ALBRECHT, MELISSA K (PT)
Entity Type:Individual
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First Name:MELISSA
Middle Name:K
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:200 NEWPORT CENTER DR
Mailing Address - Street 2:#213
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7501
Mailing Address - Country:US
Mailing Address - Phone:949-644-1322
Mailing Address - Fax:949-644-0316
Practice Address - Street 1:19000 HAWTHORNE BLVD
Practice Address - Street 2:#300
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1517
Practice Address - Country:US
Practice Address - Phone:310-793-1800
Practice Address - Fax:310-793-1801
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT 38614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGA643ZMedicare PIN