Individual
ADRIA GOPPELT TENISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT
Contact information
Practice address
3525 LOMA VISTA RD STE C, VENTURA, CA 93003-3165
(805) 652-6955
(805) 652-6959
Mailing address
5720 RALSTON ST STE 200, VENTURA, CA 93003-7844
(805) 804-4168
(805) 830-1177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
22190
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT22190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT22190
PT LICENSE
CA
Enumeration date
06/16/2010
Last updated
12/03/2021
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