Healthcare Provider Details

I. General information

NPI: 1619269842
Provider Name (Legal Business Name): ELIZABETH TREEHEART P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 CAMINO DEL RIO S STE 103
SAN DIEGO CA
92108-3520
US

IV. Provider business mailing address

2880 MEADE AVE APT 2
SAN DIEGO CA
92116-4297
US

V. Phone/Fax

Practice location:
  • Phone: 619-501-2195
  • Fax:
Mailing address:
  • Phone: 760-689-5444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number37197
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: