Healthcare Provider Details

I. General information

NPI: 1972439198
Provider Name (Legal Business Name): WENDY GREEN PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 SAXONY RD STE 202
ENCINITAS CA
92024-6777
US

IV. Provider business mailing address

171 SAXONY RD STE 202
ENCINITAS CA
92024-6777
US

V. Phone/Fax

Practice location:
  • Phone: 858-381-0614
  • Fax:
Mailing address:
  • Phone: 858-381-0614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WENDY GREEN
Title or Position: PRESIDENT
Credential: DPT
Phone: 858-381-0614