Provider Demographics
NPI:1821034893
Name:SIMSUANGCO, SHERRY B (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:B
Last Name:SIMSUANGCO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17906 PIONEER BLVD
Mailing Address - Street 2:SUITE 101 - 102
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2633
Mailing Address - Country:US
Mailing Address - Phone:562-865-2222
Mailing Address - Fax:888-423-0080
Practice Address - Street 1:17906 PIONEER BLVD
Practice Address - Street 2:SUITE 101 - 102
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2633
Practice Address - Country:US
Practice Address - Phone:562-865-2222
Practice Address - Fax:888-423-0080
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist