Provider Demographics
NPI:1942220173
Name:TOLENTINO, JANEL (PT)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:TOLENTINO
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 1:15130 BROOKHURST ST
Mailing Address - Street 2:153
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1190 BAKER ST
Practice Address - Street 2:105
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4108
Practice Address - Country:US
Practice Address - Phone:714-979-3500
Practice Address - Fax:714-979-9880
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist