Provider Demographics
NPI:1528079357
Name:CAMPA, PATRICIA (RPT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:CAMPA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 BRATTON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935
Mailing Address - Country:US
Mailing Address - Phone:619-468-3805
Mailing Address - Fax:619-425-8337
Practice Address - Street 1:1111 BROADWAY
Practice Address - Street 2:SUITE 303 US HEALTHWORKS
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911
Practice Address - Country:US
Practice Address - Phone:619-425-8172
Practice Address - Fax:619-425-8337
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 14491225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic