Provider Demographics
NPI:1790012730
Name:EBILANE-ESCALA, ELAINE JOY (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:JOY
Last Name:EBILANE-ESCALA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:JOY
Other - Last Name:EBILANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:12411 SLAUSON AVE
Mailing Address - Street 2:UNIT H
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606
Mailing Address - Country:US
Mailing Address - Phone:562-693-5449
Mailing Address - Fax:562-693-5469
Practice Address - Street 1:12411 SLAUSON AVE
Practice Address - Street 2:UNIT H
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606
Practice Address - Country:US
Practice Address - Phone:562-693-5449
Practice Address - Fax:562-693-5469
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34558225100000X
2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics