Provider Demographics
NPI:1114566049
Name:GARRISON, AMBER L (PT DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:GARRISON
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:L
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:23521 PASO DE VALENCIA #210
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92553
Mailing Address - Country:US
Mailing Address - Phone:949-597-0007
Mailing Address - Fax:949-597-0040
Practice Address - Street 1:30100 TOWN CENTER DR # YZ
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2064
Practice Address - Country:US
Practice Address - Phone:949-275-5401
Practice Address - Fax:949-276-5403
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist