Provider Demographics
NPI:1063244671
Name:BALDWIN, BRIANNA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 FOREST PARK BLVD APT 305
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-5430
Mailing Address - Country:US
Mailing Address - Phone:951-215-8182
Mailing Address - Fax:
Practice Address - Street 1:1651 E CHANNEL ISLANDS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-5617
Practice Address - Country:US
Practice Address - Phone:805-240-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist