Provider Demographics
NPI:1336977693
Name:PACINOS-GARCIA, ANABELLE RAFANAN (PT)
Entity type:Individual
Prefix:
First Name:ANABELLE
Middle Name:RAFANAN
Last Name:PACINOS-GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3989 W STETSON AVE STE 105
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-9697
Practice Address - Country:US
Practice Address - Phone:951-652-3334
Practice Address - Fax:951-652-3335
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA306322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist