Provider Demographics
NPI:1891709739
Name:CROSBY, MARIA ALEXA (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEXA
Last Name:CROSBY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ALEXA
Other - Last Name:ARNALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7506
Mailing Address - Country:US
Mailing Address - Phone:714-424-0290
Mailing Address - Fax:714-424-0278
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7506
Practice Address - Country:US
Practice Address - Phone:714-424-0290
Practice Address - Fax:714-424-0278
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT18403OtherPHYSICAL THERAPY LICENSE