Provider Demographics
NPI:1891265989
Name:SPEARMAN, DOREEN (PT)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:SPEARMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1427
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-1427
Mailing Address - Country:US
Mailing Address - Phone:909-795-4255
Mailing Address - Fax:
Practice Address - Street 1:34590 COUNTY LINE RD STE 7
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-5398
Practice Address - Country:US
Practice Address - Phone:909-795-4255
Practice Address - Fax:900-795-4438
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106992081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609180397OtherPHYSICAL THERAPY; EARLY INTERVENTION