Healthcare Provider Details

I. General information

NPI: 1417403676
Provider Name (Legal Business Name): JANA TOKUNAGA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 OTAY LAKES RD #200
CHULA VISTA CA
91910-8904
US

IV. Provider business mailing address

1601 KETTNER BLVD UNIT 11
SAN DIEGO CA
92101-2539
US

V. Phone/Fax

Practice location:
  • Phone: 619-475-6910
  • Fax:
Mailing address:
  • Phone: 619-544-1055
  • Fax: 619-544-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT291710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: