Provider Demographics
NPI:1215325303
Name:BARBOZA, MARGIE (PTA)
Entity type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:BARBOZA
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 1:27442 PORTOLA PARKWAY, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610
Mailing Address - Country:US
Mailing Address - Phone:714-871-9202
Mailing Address - Fax:
Practice Address - Street 1:27442 PORTOLA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2822
Practice Address - Country:US
Practice Address - Phone:714-871-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9241225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant