Provider Demographics
NPI:1164977419
Name:CERNA, ALEJANDRO (DPT)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:CERNA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 BROOKPINE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978-1942
Mailing Address - Country:US
Mailing Address - Phone:619-322-6920
Mailing Address - Fax:
Practice Address - Street 1:227 N EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2807
Practice Address - Country:US
Practice Address - Phone:619-322-6920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist