Provider Demographics
NPI:1285101089
Name:QUANBECK, KAREN ABALAJON SILVA (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ABALAJON SILVA
Last Name:QUANBECK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4659 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4921
Mailing Address - Country:US
Mailing Address - Phone:530-806-9126
Mailing Address - Fax:
Practice Address - Street 1:4659 OREGON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4921
Practice Address - Country:US
Practice Address - Phone:530-806-9126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist