Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | CA |
NPI | 1003094269 |
---|---|
Provider Name | Dawnielle Owens Vargas |
First Address | Vallejo, CA 94590-3248 |
Second Address | Vallejo, CA 94590-3248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 04/11/2021 |