Provider Demographics
NPI:1992242010
Name:ABITRIA, HANALEE (RPT)
Entity type:Individual
Prefix:MS
First Name:HANALEE
Middle Name:
Last Name:ABITRIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16395 ROSA LINDA LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5941
Mailing Address - Country:US
Mailing Address - Phone:909-660-9314
Mailing Address - Fax:
Practice Address - Street 1:16395 ROSA LINDA LN
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-5941
Practice Address - Country:US
Practice Address - Phone:909-660-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist