Organization Name: | PENNY LANE |
NPI Number: | 1497078471 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH BEDOYA (BILINGUAL CHILD & FAMILY SPECIALIST) |
Mailing Address: | 43520 Division St Lancaster |
State: | CA US |
Postal Code: | 935354089 |
Phone Number: | 6618163069 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2010 |
NPI Last Update Date: | 03/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |