| Doctor Name: | MS. CLYTIC MARIE VILLAS TESORIO |
| NPI Number: | 1003143041 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT-DPT |
| License Number: | |
| Business Practice Address: | 12411 Slauson Ave. Unit H Whittier, CA - 90606 |
| Business Phone Number: | 5626935449 |
| Business Fax Number: | 5626935469 |
| Mailing Address: | 12411 Slauson Ave., Unit H WHITTIER |
| State: | CA |
| Postal Code: | 90606 |
| Phone Number: | 5626935449 |
| Fax Number: | 5626935469 |
| NPI Enumeration Date: | 11/12/2009 |
| NPI Last Update Date: | 11/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |