Provider Demographics
NPI:1548154834
Name:PROM, AMARA TEVEY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AMARA
Middle Name:TEVEY
Last Name:PROM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 WHITSETT DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1751
Mailing Address - Country:US
Mailing Address - Phone:619-909-6364
Mailing Address - Fax:
Practice Address - Street 1:1405 WHITSETT DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1751
Practice Address - Country:US
Practice Address - Phone:619-909-6364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist