Healthcare Provider Details

I. General information

NPI: 1720009186
Provider Name (Legal Business Name): MOBILE THERAPISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 E PENNSYLVANIA AVENUE STE 202
ESCONDIDO CA
92025-3053
US

IV. Provider business mailing address

259 CAMINO TABLERO
ESCONDIDO CA
92029-7444
US

V. Phone/Fax

Practice location:
  • Phone: 760-291-0074
  • Fax: 760-291-0076
Mailing address:
  • Phone: 760-291-0074
  • Fax: 760-291-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA796
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT18929
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT29902
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT701
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT4366
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT2783
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT17606
License Number StateCA

VIII. Authorized Official

Name: PARISA FARAHANCHI
Title or Position: REHAB DIRECTOR
Credential: OTR
Phone: 760-809-6739