Provider Demographics
NPI:1043675903
Name:REMOQUILLO, MARIFI (DPT)
Entity type:Individual
Prefix:MISS
First Name:MARIFI
Middle Name:
Last Name:REMOQUILLO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14728 TUPPER ST
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1245
Mailing Address - Country:US
Mailing Address - Phone:818-359-3928
Mailing Address - Fax:
Practice Address - Street 1:14728 TUPPER ST
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-1245
Practice Address - Country:US
Practice Address - Phone:818-359-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-20
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist