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General NPI Number Information
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NPI Number | 1437732120
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Entity Type | Organization
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Legal Business Name | WATSON SPORTS PERFORMANCE & REHABILITATION INC
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 1000 CALLE AMANECER
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6214
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Country | US
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Telephone | 949-481-9113
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Fax | 949-481-9124
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Provider Business Mailing Address
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Address Line | 1000 CALLE AMANECER
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6214
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Country | US
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Telephone | 949-481-9113
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Fax | 949-481-9124
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Authorized Official
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Title or Position | OFFICE/ OPERATIONS MANAGER
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Name | KATY DUNCAN
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Credential |
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Telephone | 949-481-9113
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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