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General NPI Number Information
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NPI Number | 1477503514
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Entity Type | Individual
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Provider Name | ANGELA J WITUCKI O.T.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/13/2024
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Provider Practice Location Address
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Address Line | 9988 HIBERT ST STE 208
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City | SAN DIEGO
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State | CA
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Zip | 92131-2480
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Country | US
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Telephone | 858-227-7229
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Fax | 858-221-4177
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Provider Business Mailing Address
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Address Line | 1965 5TH AVE STE 170
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City | SAN DIEGO
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State | CA
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Zip | 92101-2300
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Country | US
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Telephone | 619-851-6072
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Fax | 619-241-2992
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 3375
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License Number State | CA
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