Provider Demographics
NPI:1235332503
Name:DEFELICE JARRETT, BELINDA SOPHIA (DPT)
Entity type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:SOPHIA
Last Name:DEFELICE JARRETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:BELINDA
Other - Middle Name:SOPHIA
Other - Last Name:DEFELICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:19901 ENADIA WAY
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3637
Mailing Address - Country:US
Mailing Address - Phone:818-375-1607
Mailing Address - Fax:
Practice Address - Street 1:8250 S. WOODAN AVENUE
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-375-1607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist