| Doctor Name: | TRACY SUZANNE ROBERTS-HISLOP |
| NPI Number: | 1336498211 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT 39348 |
| Business Practice Address: | 886 Magnolia Ave Suite 100 Corona, CA - 928793105 |
| Business Phone Number: | 9513403402 |
| Business Fax Number: | 9513403416 |
| Mailing Address: | 24630 Washington Ave, Ste. 200 MURRIETA |
| State: | CA |
| Postal Code: | 925626131 |
| Phone Number: | 9516969353 |
| Fax Number: | 9519737216 |
| NPI Enumeration Date: | 09/06/2012 |
| NPI Last Update Date: | 12/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 39348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |