Individual
STELLA MODERAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8090 PARKWAY DR, LA MESA, CA 91942-2105
(619) 697-3093
(619) 697-3135
Mailing address
2532 J AVE, NATIONAL CITY, CA 91950-7521
(619) 697-0018
(619) 697-0051
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT1210
CA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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