Basic Information
| Provider Information | |||||||||
| NPI: | 1851452015 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WICAL | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8328 W AVENUE E12 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935367012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617280146 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 44303 LOWTREE AVE | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935344149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6619405494 | ||||||||
| FaxNumber: | 6619400825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | PT 14761 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.