Provider Demographics
NPI:1902383466
Name:PASAMONTE SITANGANG, LORELIE JOANNE (DPT)
Entity Type:Individual
Prefix:
First Name:LORELIE
Middle Name:JOANNE
Last Name:PASAMONTE SITANGANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LORELIE
Other - Middle Name:JOANNE
Other - Last Name:PASAMONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1806 FOUNDATION LANE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928
Mailing Address - Country:US
Mailing Address - Phone:530-891-3338
Mailing Address - Fax:530-594-5771
Practice Address - Street 1:1806 FOUNDATION LANE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-891-3338
Practice Address - Fax:530-594-5771
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist