Provider Demographics
NPI:1740670496
Name:GARCIA, MARIA TERESA OBIETA (PT)
Entity type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:OBIETA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA TERESA
Other - Middle Name:OBIETA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2310 E BALL RD APT 2
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-5357
Mailing Address - Country:US
Mailing Address - Phone:714-765-9650
Mailing Address - Fax:
Practice Address - Street 1:2310 E BALL RD APT 2
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5357
Practice Address - Country:US
Practice Address - Phone:714-765-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9222225200000X
CA294229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant