Individual
MISS GABRIELLE MELISSA LOVATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
22821 LAKE FOREST DR STE 115, LAKE FOREST, CA 92630-1606
(949) 716-5050
Mailing address
23980 SANCTUARY PKWY, YORBA LINDA, CA 92887-5647
(714) 345-3955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA48173
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA48173
PT BOARD OF CA
CA
Enumeration date
01/09/2018
Last updated
01/09/2018
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