Basic Information
Provider Information
NPI: 1265089700
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADARNA
FirstName: ANNA
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Mailing Information
Address1: 20135 KESWICK ST APT 305
Address2:  
City: WINNETKA
State: CA
PostalCode: 913064417
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7120 CORBIN AVE
Address2:  
City: RESEDA
State: CA
PostalCode: 913353618
CountryCode: US
TelephoneNumber: 8188814540
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/20/2019
LastUpdateDate: 08/20/2019
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X49808CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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