Healthcare Provider Details

I. General information

NPI: 1700705852
Provider Name (Legal Business Name): RESTORE HAND AND SCAR THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9474 KEARNY VILLA RD STE 113
SAN DIEGO CA
92126-4596
US

IV. Provider business mailing address

16602 ARENA DR
RAMONA CA
92065-4109
US

V. Phone/Fax

Practice location:
  • Phone: 858-337-4596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ADRIENNE TESAREK
Title or Position: CEO
Credential:
Phone: 858-337-4596