Provider Demographics
NPI:1194466425
Name:WIJESINGHE, WATHMI SAJIKA (DPM)
Entity Type:Individual
Prefix:
First Name:WATHMI
Middle Name:SAJIKA
Last Name:WIJESINGHE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 E NANETTE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1786
Mailing Address - Country:US
Mailing Address - Phone:818-726-5730
Mailing Address - Fax:
Practice Address - Street 1:4077 FIFTH AVE # MER-35
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2105
Practice Address - Country:US
Practice Address - Phone:619-260-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program