1487886701 NPI number — MRS. JOANNE SARENA BSC.PHYSICAL THERAPY

Table of content: MRS. JOANNE SARENA BSC.PHYSICAL THERAPY (NPI 1487886701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487886701 NPI number — MRS. JOANNE SARENA BSC.PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARENA
Provider First Name:
JOANNE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BSC.PHYSICAL THERAPY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERNHAUT
Provider Other First Name:
JOANNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSC.PHYSICAL THERAPY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487886701
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
745 CLARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENCINITAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92024-2314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7510 CLAIREMONT MESA BLVD.,
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-277-2277
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  23341 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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