Provider Demographics
NPI:1154520682
Name:DOLORMENTE, RHONDA (PTA)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:DOLORMENTE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10459 MOUNTAIN VIEW AVE
Mailing Address - Street 2:STE B
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2033
Mailing Address - Country:US
Mailing Address - Phone:909-478-9508
Mailing Address - Fax:909-478-9518
Practice Address - Street 1:10459 MOUNTAIN VIEW AVE
Practice Address - Street 2:STE B
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2033
Practice Address - Country:US
Practice Address - Phone:909-478-9508
Practice Address - Fax:909-478-9518
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8365225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant