Healthcare Provider Details

I. General information

NPI: 1780548743
Provider Name (Legal Business Name): ANNA E KREVI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 MISSION AVE STE 123
OCEANSIDE CA
92058-1327
US

IV. Provider business mailing address

3355 MISSION AVE STE 123
OCEANSIDE CA
92058-1327
US

V. Phone/Fax

Practice location:
  • Phone: 760-529-4975
  • Fax: 760-529-4761
Mailing address:
  • Phone: 760-529-4975
  • Fax: 760-529-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: