Individual
VANESSA BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
10400 CANOGA AVE APT 201, CHATSWORTH, CA 91311-2293
(818) 441-9911
Mailing address
10400 CANOGA AVE APT 201, CHATSWORTH, CA 91311-2293
(818) 441-9911
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA8870
CA
Other
Enumeration date
02/27/2021
Last updated
02/27/2021
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