Provider Demographics
NPI:1285877969
Name:STERN, DEBRA SUSAN (MPT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUSAN
Last Name:STERN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:SUSAN
Other - Last Name:ZALMANOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:PO BOX 941452
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-1452
Mailing Address - Country:US
Mailing Address - Phone:805-501-1756
Mailing Address - Fax:
Practice Address - Street 1:1 CIVIC PLAZA DR
Practice Address - Street 2:SUITE 625
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2243
Practice Address - Country:US
Practice Address - Phone:805-501-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist