Doctor Name: | DR. ANDREA JAE BRENNGLASS |
NPI Number: | 1386836005 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT, ATC, CSCS |
License Number: | 33816 |
Business Practice Address: | 2901 Wilshire Blvd Ste 440 Santa Monica, CA - 904034913 |
Business Phone Number: | 3103159711 |
Business Fax Number: | |
Mailing Address: | 13900 Tahiti Way Apt 125, MARINA DEL REY |
State: | CA |
Postal Code: | 902926571 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/16/2007 |
NPI Last Update Date: | 08/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 33816 |
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 |