Provider Demographics
NPI:1831394535
Name:MORITA-NAGAI, PATRICIA JANE (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JANE
Last Name:MORITA-NAGAI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S MANCHESTER AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3217
Mailing Address - Country:US
Mailing Address - Phone:714-456-2911
Mailing Address - Fax:714-456-8383
Practice Address - Street 1:200 S MANCHESTER AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3217
Practice Address - Country:US
Practice Address - Phone:714-456-2911
Practice Address - Fax:714-456-8383
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist