Provider Demographics
NPI:1750725891
Name:TRAYLOR, MARIA DEL CARMEN (DPT)
Entity type:Individual
Prefix:DR
First Name:MARIA DEL CARMEN
Middle Name:
Last Name:TRAYLOR
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 1:22552 PETRA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1125
Mailing Address - Country:US
Mailing Address - Phone:650-793-0136
Mailing Address - Fax:
Practice Address - Street 1:32170 NIGUEL RD
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4264
Practice Address - Country:US
Practice Address - Phone:650-793-0136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 40065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH1283ZMedicare PIN