Provider Demographics
NPI:1841580941
Name:AUSTRIA, MARIFE VILLAFUERTE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:MARIFE
Middle Name:VILLAFUERTE
Last Name:AUSTRIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:MARIFE
Other - Middle Name:CAMACHO
Other - Last Name:VILLAFUERTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:44728 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3028
Mailing Address - Country:US
Mailing Address - Phone:951-306-5306
Mailing Address - Fax:
Practice Address - Street 1:44303 N. LOWTREE AVE.
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:951-306-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT335162251G0304X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics