Provider Demographics
NPI:1992168108
Name:TOBONI, JENNIFER (PT, DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TOBONI
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 1:3355 MISSION AVE STE 123
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1327
Mailing Address - Country:US
Mailing Address - Phone:760-529-4975
Mailing Address - Fax:
Practice Address - Street 1:3355 MISSION AVE STE 123
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1327
Practice Address - Country:US
Practice Address - Phone:760-529-4975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2911522251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics