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General NPI Number Information
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NPI Number | 1548967599
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Entity Type | Organization
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Legal Business Name | RESTORE PELVIC HEALTH & WELLNESS
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 7340 CALLE CRISTOBAL UNIT 92
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City | SAN DIEGO
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State | CA
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Zip | 92126-6074
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Country | US
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Telephone | 301-938-3412
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Fax |
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Provider Business Mailing Address
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Address Line | 7340 CALLE CRISTOBAL UNIT 92
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City | SAN DIEGO
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State | CA
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Zip | 92126-6074
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Country | US
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Telephone | 301-938-3412
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | REBECCA JACOBS
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Credential | OTR/L
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Telephone | 301-938-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 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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