Provider Demographics
NPI:1881737393
Name:MENEGIO, JANINA CUDANES (DPT)
Entity type:Individual
Prefix:
First Name:JANINA
Middle Name:CUDANES
Last Name:MENEGIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JANINA
Other - Middle Name:TESORO
Other - Last Name:CUDANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:21611 AUDUBON WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-5752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17332 VON KARMAN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6242
Practice Address - Country:US
Practice Address - Phone:949-861-8600
Practice Address - Fax:949-861-8601
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 33366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist