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General NPI Number Information
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NPI Number | 1154146454
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Entity Type | Individual
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Provider Name | SENA KOQUI HARLLEY PT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1154 E MAIN ST STE 106
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City | EL CAJON
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State | CA
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Zip | 92021-7169
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Country | US
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Telephone | 619-215-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 137 S LAS POSAS RD STE 254
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City | SAN MARCOS
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State | CA
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Zip | 92078-2475
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Country | US
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Telephone | 408-373-5878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 307236
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License Number State | CA
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