Healthcare Provider Details

I. General information

NPI: 1710881487
Provider Name (Legal Business Name): KAITLYN AKEMI OKI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 EASTGATE MALL STE 120
SAN DIEGO CA
92121-1980
US

IV. Provider business mailing address

4916 MOUNT LA PLATTA DR
SAN DIEGO CA
92117-3043
US

V. Phone/Fax

Practice location:
  • Phone: 858-587-8669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number311078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: