MEDICARE: JULIE CAYETANO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT19877	CA

General Provider Information

NPI Number	:	1306292800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE CAYETANO PT

Provider Business Mailing Address
First Line	:	PO BOX 90395
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92169-2395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4757 ACADEMY PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3458
Country	:	US
Telephone Number	:	858-997-5585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	03/02/2020

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