| Doctor Name: | ROBERTA RAE PENNINGTON |
| NPI Number: | 1093845299 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPT |
| License Number: | 14647 |
| Business Practice Address: | 1120 Via Callejon Suite B San Clemente, CA - 926736213 |
| Business Phone Number: | 9494985100 |
| Business Fax Number: | |
| Mailing Address: | 1120 Via Callejon, Suite B SAN CLEMENTE |
| State: | CA |
| Postal Code: | 926736213 |
| Phone Number: | 9494985100 |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 02/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 14647 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |