Provider Demographics
NPI:1992955504
Name:BROWN, JOAN BARBARA
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:BARBARA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3563 MOUND VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3625
Mailing Address - Country:US
Mailing Address - Phone:818-985-1170
Mailing Address - Fax:818-985-1171
Practice Address - Street 1:3563 MOUND VIEW AVE
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3625
Practice Address - Country:US
Practice Address - Phone:818-985-1170
Practice Address - Fax:818-985-1171
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist