Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT 25676 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT 25676 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT 25676 | CA |
NPI | 1033166236 |
---|---|
Provider Name | Mrs. Dinah D Feliciano |
First Address | Oceanside, CA 92054-5341 |
Second Address | Oceanside, CA 92054-5336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |