Provider Demographics
NPI:1851116214
Name:DEVERA, KEVIN EFREN (DPT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:EFREN
Last Name:DEVERA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26971 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-2181
Mailing Address - Country:US
Mailing Address - Phone:661-600-7573
Mailing Address - Fax:
Practice Address - Street 1:26971 HUMMINGBIRD LN
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-2181
Practice Address - Country:US
Practice Address - Phone:661-600-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist