Doctor Name: | DR. THERESA R PULICKAL |
NPI Number: | 1093032781 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | PT 36474 |
Business Practice Address: | 7862 El Cajon Blvd La Mesa, CA - 919426712 |
Business Phone Number: | 6196446452 |
Business Fax Number: | 6194667528 |
Mailing Address: | 3920 Riviera Dr, Unit G SAN DIEGO |
State: | CA |
Postal Code: | 921095835 |
Phone Number: | 7737718906 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2010 |
NPI Last Update Date: | 06/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 36474 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |