Basic Information
| Provider Information | |||||||||
| NPI: | 1831394535 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORITA-NAGAI | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 S MANCHESTER AVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144562911 | ||||||||
| FaxNumber: | 7144568383 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 S MANCHESTER AVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144562911 | ||||||||
| FaxNumber: | 7144568383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 18280 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.