Provider Demographics
NPI:1699789016
Name:FERLAND, GENEVIEVE (DPT)
Entity type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:
Last Name:FERLAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 ARTESIA BLVD
Mailing Address - Street 2:STE 207
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3419
Mailing Address - Country:US
Mailing Address - Phone:310-371-4774
Mailing Address - Fax:310-371-3453
Practice Address - Street 1:2850 ARTESIA BLVD
Practice Address - Street 2:STE 207
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3419
Practice Address - Country:US
Practice Address - Phone:310-371-4774
Practice Address - Fax:310-371-3453
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16610Medicare ID - Type Unspecified
S81166Medicare UPIN