Healthcare Provider Details

I. General information

NPI: 1003202862
Provider Name (Legal Business Name): AMY LYNN ALABY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LYNN SCHAEFER DPT

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2067 W VISTA WAY STE 185
VISTA CA
92083-6031
US

IV. Provider business mailing address

3070 MADISON ST
CARLSBAD CA
92008-2310
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-5888
  • Fax: 760-631-5880
Mailing address:
  • Phone: 760-591-7750
  • Fax: 760-294-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT42087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: