Provider Demographics
NPI:1306894696
Name:CLOUD, PAMELA E (MPT)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:E
Last Name:CLOUD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:E
Other - Last Name:HEIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:332 SANTA FE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5143
Mailing Address - Country:US
Mailing Address - Phone:760-942-4400
Mailing Address - Fax:760-942-4450
Practice Address - Street 1:332 SANTA FE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5143
Practice Address - Country:US
Practice Address - Phone:760-942-4400
Practice Address - Fax:760-942-4450
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT24273AMedicare ID - Type Unspecified