Provider Demographics
NPI:1073853537
Name:TIMBOL, ABIGAIL D (OTR/L)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:D
Last Name:TIMBOL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:DUYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10724 PENARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-5930
Mailing Address - Country:US
Mailing Address - Phone:858-361-0653
Mailing Address - Fax:
Practice Address - Street 1:4647 ZION AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2507
Practice Address - Country:US
Practice Address - Phone:619-528-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12724225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist