Provider Demographics
NPI:1275835050
Name:DANIELS, ELIZABETH JOY (PT, MPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOY
Last Name:DANIELS
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JOY
Other - Last Name:MEINERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:817 PASEO CAMARILLO
Mailing Address - Street 2:442
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-0703
Mailing Address - Country:US
Mailing Address - Phone:805-390-9476
Mailing Address - Fax:
Practice Address - Street 1:10730 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-1832
Practice Address - Country:US
Practice Address - Phone:805-647-1147
Practice Address - Fax:805-659-3754
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist