Provider Demographics
NPI:1134310220
Name:FABRIZIO, ROSEANNE MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:ROSEANNE
Middle Name:MARIE
Last Name:FABRIZIO
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 1:1940 CALGARY LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2805
Mailing Address - Country:US
Mailing Address - Phone:310-854-5949
Mailing Address - Fax:310-854-6049
Practice Address - Street 1:120 N ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3108
Practice Address - Country:US
Practice Address - Phone:310-854-5949
Practice Address - Fax:310-854-6049
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist