Individual
DIORELLA MARIEL G ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 FAIRVIEW RD, THOUSAND OAKS, CA 91361-2456
(805) 494-1233
Mailing address
2016 ALSCOT AVE, SIMI VALLEY, CA 93063-3806
(818) 687-3187
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49705
CA
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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