Individual
THERESA J O'HERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 W SANTA ANA BLVD, SANTA ANA, CA 92701-4134
(714) 347-0390
Mailing address
54 WAXWING LN, ALISO VIEJO, CA 92656-2211
(949) 395-6531
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT22836
CA
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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