Provider Demographics
NPI:1427888049
Name:EDWARDS, VICTORIA ANNE (DPT)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9964 SVL BOX
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5145
Mailing Address - Country:US
Mailing Address - Phone:760-646-2894
Mailing Address - Fax:
Practice Address - Street 1:846 W FOOTHILL BLVD STE C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3784
Practice Address - Country:US
Practice Address - Phone:909-985-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3065802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic