Provider Demographics
NPI:1164522322
Name:DUFFNER, AMY PATRICIA (PT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:PATRICIA
Last Name:DUFFNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:PATRICIA
Other - Last Name:DUFFNER-JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:750 BUENA CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-9672
Mailing Address - Country:US
Mailing Address - Phone:760-471-2116
Mailing Address - Fax:760-471-2116
Practice Address - Street 1:2333 STATE STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1691
Practice Address - Country:US
Practice Address - Phone:760-434-3912
Practice Address - Fax:760-434-3871
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21696225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics