Healthcare Provider Details

I. General information

NPI: 1649727462
Provider Name (Legal Business Name): ANN VALENTINE PT, DPT, NCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 CAMPUS POINT DR MAILCODE # 7775
LA JOLLA CA
92037-1300
US

IV. Provider business mailing address

PO BOX 232410
SAN DIEGO CA
92193-2410
US

V. Phone/Fax

Practice location:
  • Phone: 855-543-0333
  • Fax:
Mailing address:
  • Phone: 858-249-6748
  • Fax: 619-543-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number35485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: