1457406746 NPI number — DEBORAH ANN DENIO-IPEKJIAN MPT,DPT,MTC

Table of content: DEBORAH ANN DENIO-IPEKJIAN MPT,DPT,MTC (NPI 1457406746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457406746 NPI number — DEBORAH ANN DENIO-IPEKJIAN MPT,DPT,MTC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DENIO-IPEKJIAN
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MPT,DPT,MTC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457406746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4208 ROSEDALE HWY STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93308-6172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-447-5020
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4208 ROSEDALE HWY STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-6172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-447-5020
Provider Business Practice Location Address Fax Number:
310-889-0998
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  26676 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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