Provider Demographics
NPI:1316650690
Name:MENA, ABNER SIGFREDO
Entity type:Individual
Prefix:
First Name:ABNER
Middle Name:SIGFREDO
Last Name:MENA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 REGATTA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-1274
Mailing Address - Country:US
Mailing Address - Phone:562-641-6319
Mailing Address - Fax:
Practice Address - Street 1:10121 REGATTA AVE APT 2
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-1274
Practice Address - Country:US
Practice Address - Phone:562-641-6319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88879225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist