Individual
MRS. ELYSE CLAIRE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
575 EVERGREEN AVE, NEWBURY PARK, CA 91320-5127
(805) 660-2623
(805) 499-9106
Mailing address
575 EVERGREEN AVE, NEWBURY PARK, CA 91320-5127
(805) 660-2623
(805) 499-9106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
AT 936
CA
225400000X
Rehabilitation Practitioner
Primary
AT 936
CA
Other
Enumeration date
03/30/2007
Last updated
09/11/2025
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