Provider Demographics
NPI:1982097796
Name:STICKELS, JOSIANE MAURINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOSIANE
Middle Name:MAURINE
Last Name:STICKELS
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 1:2424 LOS OLIVOS LN
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3130
Mailing Address - Country:US
Mailing Address - Phone:626-428-0828
Mailing Address - Fax:
Practice Address - Street 1:2424 LOS OLIVOS LN
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3130
Practice Address - Country:US
Practice Address - Phone:626-428-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA238502251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics