Provider Demographics
NPI:1669914123
Name:ANAHEIM HILLS PEDIATRIC THERAPY INC.
Entity type:Organization
Organization Name:ANAHEIM HILLS PEDIATRIC THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREVERT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-488-8024
Mailing Address - Street 1:140 S CHAPARRAL CT STE 150
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-2283
Mailing Address - Country:US
Mailing Address - Phone:714-794-5889
Mailing Address - Fax:
Practice Address - Street 1:140 S CHAPARRAL CT STE 150
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2283
Practice Address - Country:US
Practice Address - Phone:714-794-5889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANAHEIM HILLS PEDIATRIC THERAPY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35048261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy