Provider Demographics
NPI:1518307123
Name:HUGHES, LAURA K (DPT)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2314
Mailing Address - Country:US
Mailing Address - Phone:808-345-7776
Mailing Address - Fax:
Practice Address - Street 1:10783 JAMACHA BLVD STE 7
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91978-1842
Practice Address - Country:US
Practice Address - Phone:619-670-1711
Practice Address - Fax:619-670-1712
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist