Provider Demographics
NPI:1083830616
Name:JUNGLING, NANCY B (MSPT)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:B
Last Name:JUNGLING
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:B
Other - Last Name:ZAVALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:300 FIR ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2327
Mailing Address - Country:US
Mailing Address - Phone:619-446-1730
Mailing Address - Fax:619-446-1737
Practice Address - Street 1:300 FIR ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2327
Practice Address - Country:US
Practice Address - Phone:619-446-1730
Practice Address - Fax:619-446-1737
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist