Provider Demographics
NPI:1912142639
Name:SUMMERS, RITA LA JEAN (RPT)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:LA JEAN
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 W SUNSET BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3429
Mailing Address - Country:US
Mailing Address - Phone:323-874-1912
Mailing Address - Fax:323-874-2208
Practice Address - Street 1:7300 W SUNSET BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3429
Practice Address - Country:US
Practice Address - Phone:323-874-1912
Practice Address - Fax:323-874-2208
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist