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Individual

INGRID MICHELLE NAVEIRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
126 CHEESBROUGHS LN, LOS ANGELES, CA 90063-2839
(909) 657-6773
Mailing address
126 CHEESBROUGHS LN, LOS ANGELES, CA 90063-2839

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2251S0007X
Sports Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002571777
IHSS
CA
Enumeration date
12/05/2019
Last updated
12/27/2019
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