Provider Demographics
NPI:1396886487
Name:LIMON-SMITH, LORRAINE (PTA)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:LIMON-SMITH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 N SANTA ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3114
Mailing Address - Country:US
Mailing Address - Phone:626-294-0070
Mailing Address - Fax:626-294-0080
Practice Address - Street 1:253 N SANTA ANITA AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3114
Practice Address - Country:US
Practice Address - Phone:626-294-0070
Practice Address - Fax:626-294-0080
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT699225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant