Individual
JULIE TERI EZAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 W SANTA ANA BLVD, #100, SANTA ANA, CA 92701-4134
(714) 347-0300
Mailing address
24171 PAVION, MISSION VIEJO, CA 92692-2200
(949) 707-2190
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 5059
CA
Other
Enumeration date
05/26/2006
Last updated
07/16/2007
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