Provider Demographics
NPI:1003119587
Name:YACOBOVSKY, ALONA MARY (DPT, CWS, COMT)
Entity Type:Individual
Prefix:DR
First Name:ALONA
Middle Name:MARY
Last Name:YACOBOVSKY
Suffix:
Gender:F
Credentials:DPT, CWS, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8555 STATION VILLAGE LN APT 3217
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-6542
Mailing Address - Country:US
Mailing Address - Phone:702-525-9299
Mailing Address - Fax:
Practice Address - Street 1:8555 STATION VILLAGE LN APT 3217
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-6542
Practice Address - Country:US
Practice Address - Phone:702-525-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist