Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michelle Derouso, PTA

Individual provider Physical Therapy Assistant · NPI 1134893316

Michelle Derouso, PTA is a Physical Therapy Assistant in Lake Forest, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

26342 Forest Ridge Dr Unit 5C
Lake Forest, CA 92630-7820
Phone: (714) 943-3709
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Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 49501 (CA)

Record details

NPI number1134893316
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedAugust 2, 2021
Last updated in NPPESAugust 2, 2021
Certification dateAugust 2, 2021
Mailing address26342 Forest Ridge Dr Unit 5c, Lake Forest, CA 92630-7820

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