Provider Demographics
NPI:1700089034
Name:VOCAL, LUDY SISON
Entity Type:Individual
Prefix:
First Name:LUDY
Middle Name:SISON
Last Name:VOCAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUDY
Other - Middle Name:AQUINO
Other - Last Name:SISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA PHYSICAL THERAPI
Mailing Address - Street 1:4560 SE INTERNATIONAL WAY
Mailing Address - Street 2:CONSONUS HEALTHCARE SERVICES SUITE 100
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222
Mailing Address - Country:US
Mailing Address - Phone:971-206-5129
Mailing Address - Fax:971-206-5209
Practice Address - Street 1:4367 CONCORD BLVD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521
Practice Address - Country:US
Practice Address - Phone:925-689-7457
Practice Address - Fax:925-825-4967
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT6696225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant