Provider Demographics
NPI:1902019680
Name:HATCH, LEZA L (PT, OCS, COS-C)
Entity Type:Individual
Prefix:
First Name:LEZA
Middle Name:L
Last Name:HATCH
Suffix:
Gender:F
Credentials:PT, OCS, COS-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 OLIVE DRIVE
Mailing Address - Street 2:UNIT NUMBER 59
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-4182
Mailing Address - Country:US
Mailing Address - Phone:661-205-7080
Mailing Address - Fax:661-399-5733
Practice Address - Street 1:930 OLIVE DRIVE
Practice Address - Street 2:UNIT NUMBER 59
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-4182
Practice Address - Country:US
Practice Address - Phone:661-205-7080
Practice Address - Fax:661-399-5733
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA189792251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic