Provider Demographics
NPI:1396509097
Name:WHITFORD, ANELI LIV (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANELI
Middle Name:LIV
Last Name:WHITFORD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 MISSION AVE APT C101
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6725
Mailing Address - Country:US
Mailing Address - Phone:909-261-6819
Mailing Address - Fax:
Practice Address - Street 1:13001 SEAL BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2754
Practice Address - Country:US
Practice Address - Phone:909-261-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3032642251N0400X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology