Provider Demographics
NPI:1710225842
Name:WAY, PAULA (LPT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WAY
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:401 W ORANGEWOOD AVE APT E108
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-5256
Mailing Address - Country:US
Mailing Address - Phone:310-525-8635
Mailing Address - Fax:310-525-8635
Practice Address - Street 1:6060 N PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3711
Practice Address - Country:US
Practice Address - Phone:562-790-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA36027225400000X, 167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician