Healthcare Provider Details

I. General information

NPI: 1982889499
Provider Name (Legal Business Name): MOBILE THERAPY AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 10/05/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LANTERN CREST WAY
SANTEE CA
92071-4775
US

IV. Provider business mailing address

PO BOX N
DEL MAR CA
92014-0376
US

V. Phone/Fax

Practice location:
  • Phone: 858-229-6666
  • Fax: 877-292-8360
Mailing address:
  • Phone: 858-229-8666
  • Fax: 877-292-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT29711
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4969
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP9821
License Number StateCA

VIII. Authorized Official

Name: MS. SANDRA MARIE SABONJIAN
Title or Position: PARTNER
Credential: M.A., CCC-SLP
Phone: 858-229-8666