Provider Demographics
NPI:1306242847
Name:WONNELL, ABIGAIL CRISTIN (MS, ATC)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:CRISTIN
Last Name:WONNELL
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:MS
Other - First Name:ABBIE
Other - Middle Name:CRISTIN
Other - Last Name:WONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:7773 SAINT BERNARD ST
Mailing Address - Street 2:APT 4
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7358
Mailing Address - Country:US
Mailing Address - Phone:213-309-9339
Mailing Address - Fax:213-740-0889
Practice Address - Street 1:3400 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-2300
Practice Address - Country:US
Practice Address - Phone:213-740-0929
Practice Address - Fax:213-740-0889
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer