Provider Demographics
NPI:1194979070
Name:CHRISTIANSON, NANSY PEREZ (PT)
Entity type:Individual
Prefix:
First Name:NANSY
Middle Name:PEREZ
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 SOUTH SANTA FE, SUITE 401
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-5750
Mailing Address - Country:US
Mailing Address - Phone:951-487-9317
Mailing Address - Fax:951-487-9371
Practice Address - Street 1:1604 SOUTH SANTA FE, SUITE 401
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5750
Practice Address - Country:US
Practice Address - Phone:951-487-9317
Practice Address - Fax:951-487-9371
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT35038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist