Provider Demographics
NPI:1811063951
Name:RIATE, ANNE MARIE LOARCA (PT)
Entity type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:LOARCA
Last Name:RIATE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANNE MARIE
Other - Middle Name:LAZARO
Other - Last Name:LOARCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24344 DARRIN DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1842
Mailing Address - Country:US
Mailing Address - Phone:626-780-4181
Mailing Address - Fax:
Practice Address - Street 1:1135 S SUNSET AVE STE 101
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3938
Practice Address - Country:US
Practice Address - Phone:909-517-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT28912AMedicare PIN
CAWPT28912AMedicare ID - Type Unspecified