Healthcare Provider Details
I. General information
NPI: 1508742099
Provider Name (Legal Business Name): OLIVIA DAPHNE ZINA PT. DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4725 MARKET ST BLDG A
SAN DIEGO CA
92102-4715
US
IV. Provider business mailing address
3516 WILSHIRE TER
SAN DIEGO CA
92104-6215
US
V. Phone/Fax
- Phone: 619-515-2560
- Fax:
- Phone: 720-470-2725
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 308676 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: