Provider Demographics
NPI:1023114055
Name:PHYSICAL THERAPY FOR HEALTH, INC
Entity type:Organization
Organization Name:PHYSICAL THERAPY FOR HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES BELLA
Authorized Official - Middle Name:LAREZA
Authorized Official - Last Name:BOURDON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:650-947-0121
Mailing Address - Street 1:851 FREMONT AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5698
Mailing Address - Country:US
Mailing Address - Phone:650-947-0121
Mailing Address - Fax:650-947-0121
Practice Address - Street 1:851 FREMONT AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5698
Practice Address - Country:US
Practice Address - Phone:650-947-0121
Practice Address - Fax:650-947-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty