Basic Information
Provider Information
NPI: 1881817971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANCO
FirstName: MICHELE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16263 MINNEHAHA ST
Address2:  
City: GRANADA HILLS
State: CA
PostalCode: 913446837
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5601 DESOTO AVE
Address2:  
City: WOODLAND HILLS
State: CA
PostalCode: 91365
CountryCode: US
TelephoneNumber: 8187192930
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/10/2007
LastUpdateDate: 11/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT 13728CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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