Provider Demographics
NPI:1306661319
Name:ZABOROWSKA, IWONA (PTA)
Entity type:Individual
Prefix:
First Name:IWONA
Middle Name:
Last Name:ZABOROWSKA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 WALL ST UNIT 762
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92038-7032
Mailing Address - Country:US
Mailing Address - Phone:224-415-4802
Mailing Address - Fax:
Practice Address - Street 1:1140 WALL ST UNIT 762
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92038-7032
Practice Address - Country:US
Practice Address - Phone:224-415-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53642225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant